Nursing exam 1
Continuing Care
* For people who are disabled, functionally dependent, or suffering a terminal disease * Available within institutional settings or in the home: 1. Nursing centers or facilities 2. Assisted living 3. Respite care 4. Adult day care centers 5. Palliative and Hospice Care
The 21st century impacted nursing by?
*Changing curriculum to meet changing societal needs *Advances in tech and informatics requires nurses to have a strong and current knowledge base *End-of-life care and practices added to nursing curricula
Trends in Nursing
*Evidence-based practice *Quality and Safety Education for Nurses (QSEN) *Impact of emerging technologies *Genomics *Public perception of nursing *Impact of nursing on politics and health policy
Orem's Self-Care Deficit Nursing Theory
-Focuses on patient's self-care needs -Continually assess how much self-care a patient is able to perform. -Grand theory
Evidence Based Practice...
-Looks for the very best scientific and clinical evidence for treating and managing a problem -Improves quality, safety, and patient outcomes -Increases nurse satisfaction -Reduces costs
PICOT
-Population -Intervention -Comparison -Outcome -Time
Discharge planning
1. Develops plan for continuing care 2. Determines post-hospital destination Identifies patient needs 3. Begins process while still hospitalized
Traditional Levels of Health Care
1. Preventative 2. Primary 3. Secondary 4. Tertiary 5. Restorative 6. Continuing health care
Restorative Services
1. Serves patients recovering from an acute or chronic illness/disability 2. Helps individuals regain maximal function and enhance quality of life 3. Home care 4. Rehabilitation 5. Extended care facilities
Nursing: Scope and Standards of Practice
1960: Documentation began Standards of Practice Standards of Professional Performance, code of ethics
Nursing Research
A way to identify new knowledge, improve professional education and practice, and use resources effectively
Therapeutic Communication
Active listening Empathy Hope Humor Feelings Paraphrasing touch silence clarification Focusing validation
Open ended question
Allows free form communication Words like what, how, where, when
Nontherapeutic communication techniques
Asking personal questions Giving personal opinions Changing the subject Automatic responses False reassurance Sympathy Asking for explanations Approval or disapproval Defensive responses Passive or aggressive responses Arguing
Responsibilty and roles
Caregiver, Advocate, Educator, Communicator, Manager,
Professionalism Requires
Critical Thinking, Patient centered care, quality care, responsibility and accountability.
Florence Nightingale
Established sanitary nursing care units. Founder of modern nursing. began professional education of nursing. Established first nursing philosophy.
Hospice care
Focuses on palliative (not curative) care
Contemporary Influences
Importance of nurses' self-care Health care reform and costs Demographic changes Medically underserved
small group communication
Interaction within a person's spiritual domain
Public
Interactions with a small number of people
ICN
International Council of Nurses
Nursing Requires
Knowledge and practice standards, compassionate approach, critical thinking
Assisted Living
Long-term care setting Home environment Greater resident autonomy No fee caps
Documentation
Patient Chart is a legal document Make straight line through error Must be accurate, timely, and consise
Primary and Preventative...
Preventive Care 1. Improved health outcomes for an entire population 2. Reduces and controls risk factors for disease Examples: Family Doctor, Nurse Practitioner Primary care 1. Focuses on improved health outcomes 2. Requires collaboration Examples: CDC, WHO
Career Development
Provider of care Advanced practice registered nurses Clinical nurse specialist Nurse practitioner Nurse Midwife CRNA Nurse educator Nurse administrator Nurse researcher
Respite Care
Respite care provides short-term relief or "time off" for people providing home care to an individual who is ill, disabled, or frail.
A patient who needs nursing and rehabilitation following a stroke would most benefit from receiving care at a:
Restorative Care Setting
SBAR
S: Situation: What is presently happening to warrant SBAR B: Background: Events leading to situation A: Assessment: What do you think the problem is? R: Recommendation: What would you do to correct the problem?
Secondary and Tertiary Care
Secondary: Provided by a specialist upon referral from PCP Tertiary: Specialized consultative care, usually provided on referral from secondary medical personnel
When to use SBAR
Shift report Transfer from unit or institutions Provider calls
Theory Based Nursing practice
Theory generates nursing knowledge for use in practice, thus supporting EBP
interpersonal communication
communication with oneself
transpersonal communication
interaction with an audience
Closed questions
limit answer options Yes or No
Stages of Nursing Proficiency
novice, advanced beginner, competent, proficient, expert
Nursing is defined as a profession because?
practice autonomy
Forms of communication
•Verbal (language) •Nonverbal (body language) -Facial expressions, touch, eye contact -Posture, gait, gestures -General physical appearance -Mode of dress and grooming -Sounds, silence -Electronic communication
Nightingale's Environmental Theory
-Environment as the focus of nursing care -Grand theory
Communication
-Essential for establishing nurse-patient relationships and delivering patient-centered care -Helps to reduce the risk of errors -Maintains effective relationships
Evolution of nursing Theory
-First nursing theorist: Florence Nightingale -Curriculum era: 1900-1940s -Research era: 1950-1970s -Graduate education era: 1950-1970s -Theory era: 1980-1990s -Theory utilization era: 2000s-today
Peplau's Interpersonal Theory
-Focus on interpersonal relations between nurse, patient, and patient's family -Phases: preorientation, orientation, working, resolution -Middle-range theory
Link Between Theory and Knowledge Development
-Nursing knowledge is theoretical and experiential. -The goals of theoretical knowledge are to stimulate thinking and create a broad understanding of nursing science and practice. -Experiential knowledge, or the "art" of nursing, is based on nurses' experiences in providing care to patients.
Phases of the helping relationship
-Preinteraction phase -Orientation phase -Working phase -Termination phase
Therapeutic communication
-Promotes personal growth -Helps patients reach their health-related goals
Patient Centered Care
-Respect for patients' values, preferences, and expressed needs -Coordination and integration of care -Information and education -Physical comfort -Emotional support and alleviation of fear and anxiety -Involvement of family and friends -Continuity and transition -Access to care
Nurses?
-Respond to needs of patients -Actively participate in policy -Respond and adapt to challenges -Make clinical judgments and decisions about patients' health care needs based on knowledge, experience, and standards of care
Scientific Method
-The foundation of research -The most reliable and objective means of acquiring and conducting research and gaining knowledge. -Step-by-step process to ensure validity, reliability and generalizability.
Relationship Between Nursing Theory and Nursing Research
-Theories provide direction for nursing research. -Nursing theory and nursing research build the knowledge base for nursing, which is then applied to practice.
Nursing Theory
-Theory is the foundation for the art and science of nursing. -Theory, research, and practice are bound together in a continuous interactive relationship.
Leininger's Culture Care Theory
-Theory of cultural care diversity and universality -Integrates patients' cultural traditions, values, and beliefs into care plans
ANA
American Nurses Association
intrapersonal communication
One to one two people
palliative care
Patient- and family-centered care approach with a goal of improving the quality of life of patients and families who are experiencing problems related to life-threatening illnesses.
