NUTH Final Exam Review

Malpractice (unintentional tort)

Unintentional torts arise when a person is harmed and the person inflicting the harm knew, or should have known, that his or her actions were less than the accepted scope and standard of practice.

Nurses in a community clinic are conducting an EBP project focused on improving the outcomes of children with asthma. The PICO question asked by the nurses is "In school-aged children, does the use of an electronic gaming education module versus educational book improve the usage of inhalers?" In the question, what is the "O"? 1. School-aged children 2. Educational book 3. Use of inhalers 4. Electronic gaming education

Use of inhalers

Good Samaritan Law

encourage health care professionals to assist in emergencies (Furrow et al., 2018). These laws limit liability and offer legal immunity if a nurse helps at the scene of an accident. For example, if you stop at the scene of an automobile accident and give appropriate emergency care such as applying pressure to stop hemorrhage, you are acting within accepted standards, even though proper equipment is unavailable.

translation research

focuses on "testing implementation interventions to improve uptake and use of evidence to improve patient outcomes and population health" It is also called implementation science. The purpose of studies in translation research is to test implementation strategies to determine which strategies work best to promote use of EBP

Negligence (untentional tort)

conduct that falls below the generally accepted standard of care of a reasonably prudent person. A nurse is negligent when he or she had a duty of care that is breached and a patient is physically harmed.

Participant of approval: confidentiality

guarantees that any information a subject provides will not be reported in any manner that identifies the subject and will not be accessible to people outside the research team.

Middle Range Theory:Peplau's Interpersonal Theory

◦Focus on interpersonal relationship between nurse, patient, and patient's family ◦Phases: preorientation, orientation, working, resolution ◦Prominent in mental health nursing

Statutory Laws

criminal law (felonies or misdemeanors); example: criminal mistreatment of vulnerable adults provide punishment for crimes looks at the intent of the person who committed the crime civil laws which protect the rights of individuals, define the standards which are met and is based on the state distinguish nursing from other health professions

Intentional Torts

deliberate acts against a person or his or her property that may result in both civil and criminal actions.

Evaluate the Outcomes of the Practice Decision or Change

determine whether the change was effective, whether modifications in the change are needed, or whether the change needs to be discontinued. Events or results that you do not expect may occur.

PSDA (Patient Self-Determination Act)

enacted in 1991 requires health care institutions to provide written information to patients concerning their rights to make decisions about their care, including the right to refuse treatment and to formulate an advance directive.

Grand Theory: Roy's Adaptation Model

◦Method for nurses to help a patient cope with or adapt to changes in physiological, self-concept, role function, and interdependence domains ◦Adaptation occurs when the patient responds positively, leading to favorable health outcomes

Middle Range Theory: Leininger's Cultural Care Theory

◦Theory of cultural care diversity and universality ◦Integrates patients' cultural traditions, values, and beliefs into care plans

compassion fatigue

- state of burnout and secondary traumatic stress

nursing research

A way to identify new knowledge, improve professional education and practice, and use resources effectively Many professional and specialty nursing organizations support the conduct of research for advancing nursing science.

Communicate the outcomes of the evidence-based practice decision.

After implementing an EBP change, it is important to communicate the results through: -Clinical staff on the unit -Nursing practice council or the research council -Clinicians -Professional conferences and meeting

Using Maslow's hierarchy of needs, identify the priority for a patient who is experiencing chest pain and difficulty breathing. 1. Self-actualization 2. Air, water, and nutrition 3. Safety 4. Esteem and self-esteem needs

Air, water, and nutrition

Slander

An quasi- intentional tort -occurs when one speaks falsely about another.

Integrate the evidence.

Apply the research in your plan of care for a patient; use evidence as rationale. Education about the change must occur.

The nurse is discussing the advantages of using computerized provider order entry (CPOE) with a nursing colleague. Which statement best describes the major advantage of a CPOE system within an electronic health record? 1. CPOE reduces the time necessary for health care providers to write orders. 2. CPOE reduces the time needed for nurses to communicate with health care providers. 3. Nurses do not need to acknowledge orders entered by CPOE in an electronic health record. 4. CPOE improves patient safety by reducing transcription errors.

CPOE improves patient safety by reducing transcription errors.

You are floated to work on a nursing unit where you are given an assignment that is beyond your capability. Which is the best nursing action to take first? 1. Call the nursing supervisor to discuss the situation. 2. Discuss the problem with a colleague. 3. Leave the nursing unit and go home. 4. Say nothing and begin your work

Call the nursing supervisor to discuss the situation.

Proof of Negligence

Certain criteria are necessary to establish nursing malpractice: (1) the nurse (defendant) owed a duty of care to the patient (plaintiff), (2) the nurse did not carry out or breached that duty, (3) the patient was injured due to the breach in duty, and (4) damages or remedies are allowed under state law to "make the person whole" in the eyes of the court.

A nurse implements an EBP change that teaches patients the importance of taking their diabetes medications correctly and regularly on time using videos streamed on the Internet. The nurse measures the patients' behavioral outcome from the practice change using which type of measurement? 1. Measuring the patient's weight 2. Chart auditing teaching sessions 3. Observing patients viewing the videos 4. Checking patients' blood sugars

Checking patients' blood sugars

Which of the following statements indicate that the new nursing graduate understands ways to remain involved professionally? (Select all that apply.) 1. "I am thinking about joining the health committee at my church." 2. "I need to read newspapers, watch news broadcasts, and search the Internet for information related to health." 3. "I will join nursing committees at the hospital after I have completed orientation and better understand the issues affecting nursing." 4. "Nurses do not have very much voice in legislation in Washington, DC, because of the nursing shortage." 5. "I will go back to school as soon as I finish orientation."

"I am thinking about joining the health committee at my church." "I need to read newspapers, watch news broadcasts, and search the Internet for information related to health." "I will join nursing committees at the hospital after I have completed orientation and better understand the issues affecting nursing."

Guidelines specific to written documentation

(1) failing to record pertinent health or drug information (2) failing to record nursing actions (3) failing to record medication administration (4) failing to record drug reactions or changes in patients' conditions (5) incomplete or illegible records (6) failing to document discontinued medications.

Battery

(intentional tort) any intentional offensive touching without consent or lawful justification. The contact can be harmful to the patient and cause an injury, or it merely can be offensive to the patient's personal dignity.

The nurse contacts a provider about a change in a patient's condition and receives several new orders for the patient over the phone. When documenting telephone orders in the electronic health record, most hospitals require a nurse to do which of the following? 1. Print out a copy of all telephone orders entered into the electronic health record in order to keep them in personal records for legal purposes. 2. "Read back" all telephone orders to the provider over the phone to verify all orders were heard, understood, and transcribed correctly before entering the orders in the electronic health record. 3. Record telephone orders in the electronic health record, but wait to implement the order(s) until they are electronically signed by the health care provider who gave them. 4. Implement telephone order(s) immediately, but insist that the health care provider come to the patient care unit to personally enter the order(s) into the electronic health record within the next 24 hours.

"Read back" all telephone orders to the provider over the phone to verify all orders were heard, understood, and transcribed correctly before entering the orders in the electronic health record.

false imprionment

( intentional tort) The confinement of a person without legal authority or the person's consent.

Assault

(intentional tort) threat or attempt to injure

What are the stepf of evidence-based practice?

0. Cultivate a spirit of inquiry. 1. Ask a clinical question in PICOT format. 2. Search for the best evidence. 3. Critically appraise the evidence. 4. Integrate the evidence. 5. Evaluate the outcomes of practice decision or changes. 6. Communicate the outcomes of the evidence-based practice decision.

he nurse is changing the dressing over the midline incision of a patient who had surgery. Assessment of the incision reveals changes from what was documented by the previous nurse. After documenting the current wound assessment, the nurse contacts the surgeon (Dr. Oakman) by telephone to discuss changes in the incision that are of concern. Which of the following illustrates the most appropriate way for the nurse to document this conversation? 1. Health care provider notified about change in assessment of abdominal incision. T. Wright, RN 2. 09-3-18: Notified Dr. Oakman by phone that there is a new area of redness around the patient's incision. T. Wright, RN 3. 1015: Contacted Dr. Oakman and notified about changes in abdominal incision. T. Wright, RN 4. 09-3-18 (1015): Dr. Oakman contacted by phone. Notified about new area of bright red erythema extending approximately 1 inch around circumference of midline abdominal incision and oral temperature of 101.5 F. No orders received. T. Wright, RN

09-3-18 (1015): Dr. Oakman contacted by phone. Notified about new area of bright red erythema extending approximately 1 inch around circumference of midline abdominal incision and oral temperature of 101.5 F. No orders received. T. Wright, RN

Match the components of PICO using the question "Does the use of guided imagery compared with standard care decrease the postoperative pain in hospitalized adolescents?" _____ (P) Patient/population A. Adolescents receiving standard care _____ (I) Intervention B. Decreased postoperative pain _____ (C) Comparison C. Hospitalized adolescents _____ (O) Outcome D. Guided imagery

1. C 2. D 3.A 4. B

Match the following types of theory with the appropriate description. 1. Middle-range theory 2. Shared theory 3. Grand theory 4. Practice theory a. Very abstract; attempts to describe nursing in a global context b. Specific to a particular situation; brings theory to the bedside c. Applies theory from other disciplines to nursing practice d. Addresses a specific phenomenon and reflects practice

1. D 2. C 3. A 4. B

informed consent (key elements)

1. The patient receives an explanation of the procedure or treatment. 2. The patient receives the names and qualifications of people performing and assisting in the procedure. 3. The patient receives a description of the serious harm, including death, that may occur as a result of the procedure and anticipated pain and/or discomfort. 4. The patient receives an explanation of alternative therapies to the proposed procedure/treatment and the risks of doing nothing. 5. The patient knows that he or she has the right to refuse the procedure/treatment without discontinuing other supportive care. 6. The patient knows that he or she may refuse the procedure/treatment even after the procedure has begun.

Libel

A quasi- intentional tort, is the written defamation of character (e.g., charting false defamatory entries in a medical record)

The components of the nursing metaparadigm include: 1. Person, health, environment, and theory. 2. Health, theory, concepts, and environment. 3. Nurses, physicians, health, and patient needs. 4. Person, health, environment, and nursing.

4. Person, health, environment, and nursing.

Which of the following are outcomes measurements? (Select all that apply.) 1. A nurse teaches a patient how to administer an injection and then observes the patient do a return demonstration. 2. A nurse implements a new pain-management protocol and checks patients' charts to confirm whether interventions are being provided. 3. A nursing unit adopts a set of strategies for reducing pressure injuries, and the UPC members use direct observation of the skin to measure incidence of pressure injuries. 4. A nursing unit implements a new fall-prevention protocol and checks the monthly performance data for incidence of falls on the unit. 5. A nursing unit implements a patient rounding program, and the charge nurse watches the assistive personnel to see whether hourly rounding is being done on patients.

A nurse teaches a patient how to administer an injection and then observes the patient do a return demonstration. A nursing unit adopts a set of strategies for reducing pressure injuries, and the UPC members use direct observation of the skin to measure incidence of pressure injuries. A nursing unit implements a new fall-prevention protocol and checks the monthly performance data for incidence of falls on the unit.

invasion of privacy

A quasi- intentional tort revealing personal information about an individual without his or her consent

The nurse who works at the local hospital is transferring a patient to an acute rehabilitation center in another town. To complete the transfer, information from the patient's electronic health record must be printed and faxed to the acute rehabilitation center. Which of the following actions is most appropriate for the nurse to take to maintain privacy and confidentiality of the patient's information when faxing this information? (Select all that apply.) 1. Confirm that the fax number for the acute rehabilitation center is correct before sending the fax. 2. Use the encryption feature on the fax machine to encode the information and make it impossible for staff at the acute rehabilitation center to read the information unless they have the encryption key. 3. Fax the patient's information without a cover sheet so that the person receiving the information at the acute rehabilitation center can identify it more quickly. 4. After sending the fax, place the information that was printed out in a standard trash can after ripping it into several pieces. 5. After sending the fax, place the information that was printed out in a secure canister marked for shredding.

Confirm that the fax number for the acute rehabilitation center is correct before sending the fax. Use the encryption feature on the fax machine to encode the information and make it impossible for staff at the acute rehabilitation center to read the information unless they have the encryption key. After sending the fax, place the information that was printed out in a secure canister marked for shredding.

Cultivate Inquiry

Constantly questioning current practices lead to consistent use of EBP where EBP institutions demonstrate a culture in which nurses are encouraged to question practices.

A home health nurse notices significant bruising on a 2-year-old patient's head, arms, abdomen, and legs. The patient's mother describes the patient's frequent falls. What is the best nursing action for the home health nurse to take? 1. Document her findings and treat the patient. 2. Instruct the mother on safe handling of a 2-year-old child. 3. Contact a child abuse hotline. 4. Discuss this story with a colleague.

Contact a child abuse hotline.

theory is essential to nursing practice because it: (Select all that apply.) 1. Contributes to nursing knowledge. 2. Predicts patient behaviors in situations. 3. Provides a means of assessing patient vital signs. 4. Guides nursing practice. 5. Formulates health care legislation. 6. Explains relationships between concepts

Contributes to nursing knowledge. Predicts patient behaviors in situations. Guides nursing practice.

Place the steps of the EBP process in the appropriate order. 1. Critically appraise the evidence you gather. 2. Ask the clinical question in PICOT format. 3. Evaluate the outcomes of the practice decision or change. 4. Search for the most relevant and best evidence. 5. Cultivate a spirit of inquiry. 6. Integrate the evidence. 7. Communicate the outcomes of the EBP change.

Cultivate a spirit of inquiry. Ask the clinical question in PICOT format. Search for the most relevant and best evidence. Critically appraise the evidence you gather. Integrate the evidence. Evaluate the outcomes of the practice decision or change. Communicate the outcome of the EBP change

Defintion relating to theory

Definitions may be theoretical/conceptual or operational. Theoretical or conceptual definitions simply define a particular concept, much like what can be found in a dictionary, based on the theorist's perspective

A man who is homeless enters the emergency department seeking health care. The health care provider indicates that the patient needs to be transferred to the city hospital for care before assessing the patient. This action is most likely a violation of which of the following laws? 1. Health Insurance Portability and Accountability Act (HIPAA) 2. Americans with Disabilities Act (ADA) 3. Patient Self-Determination Act (PSDA) 4. Emergency Medical Treatment and Active Labor Act (EMTALA)

Emergency Medical Treatment and Active Labor Act (EMTALA)

Generalizability

Extent to which research results apply to a range of individuals not included in the study.

A patient is in skeletal traction and has a plaster cast due to a fractured femur. The patient experiences decreased sensation and a cold feeling in the toes of the affected leg. The nurse observes that the patient's toes have become pale and cold but forgets to document this because one of the nurse's other patients experienced cardiac arrest at the same time. Two days later the patient in skeletal traction has an elevated temperature, and he is prepared for surgery to amputate the leg below the knee. Which of the following statements regarding a breach of duty apply to this situation? (Select all that apply.) 1. Failure to document a change in assessment data 2. Failure to provide discharge instructions 3. Failure to provide patient education about cast care. 4. Failure to use proper medical equipment ordered for patient monitoring 5. Failure to notify a health care provider about a change in the patient's condition

Failure to document a change in assessment data Failure to notify a health care provider about a change in the patient's condition

A woman has severe life-threatening injuries, is unresponsive, and is hemorrhaging following a car accident. The health care provider ordered two units of packed red blood cells to treat the woman's anemia. The woman's husband refuses to allow the nurse to give his wife the blood for religious reasons. What is the nurse's responsibility? 1. Obtain a court order to give the blood. 2. Convince the husband to allow the nurse to give the blood. 3. Call security and have the husband removed from the hospital. 4. Gather more information about the wife's preferences and determine whether the husband is her power of attorney for health care.

Gather more information about the wife's preferences and determine whether the husband is her power of attorney for health care.

Theory

Helps explain an event by defining ideas or concepts, explaining relationships among the concepts, and predicts ouutcomes

Scope of Practice

The scope of nursing practice defines nursing and reflects the values of the nursing profession

exhaustion stage

In the stage continuous stress causes progressive breakdown of compensatory mechanisms. This occurs when the body is no longer able to resist the effects of the stressor and has depleted the energy necessary to maintain adaptation. The physiological response has intensified, but the person's ability to adapt to the stressor diminishes

The nurse is reviewing health care provider orders that were handwritten on paper when all computers were down during a system upgrade. Which of the following orders contain an inappropriate abbreviation included on The Joint Commission's "Do Not Use" list and should be clarified with the health care provider? 1. Change open midline abdominal incision daily using wet-to-moist normal saline and gauze. 2. Lorazepam 0.5 mg PO every 4 hours prn anxiety 3. Morphine sulfate 1 mg IVP every 2 hours prn severe pain 4. Insulin aspart 8u SQ every morning before breakfast

Insulin aspart 8u SQ every morning before breakfast

Nursing students -liability if harm to patient/incorrect action

Liable if their actions exceed their scope of practice and cause harm to patients

The nurses on a medical unit have seen an increase in the number of pressure injuries developing in their patients. The nurses decide to initiate a performance improvement project using the PDSA model. Which of the following is an example of "Plan" from that model? 1. Orienting patients to the unit's practice of hourly rounding on patients 2. Reviewing the incidence of pressure injuries on patients cared for using the protocol 3. Based on findings from patients who developed injuries, implementing an evidence-based skin care protocol on all units 4. Meeting with all disciplines to develop a multidisciplinary approach for reducing pressure injuries

Meeting with all disciplines to develop a multidisciplinary approach for reducing pressure injuries

Theory related to nursing

Metatheory looks at the relationships of various components that make up the knowledge of a discipline

Most common source for malpractice claims in a health care setting

Most malpractice and professional licensure claims occur in hospital settings.

A nurse ensures that each patient's room is clean; well ventilated; and free from clutter, excessive noise, and extremes in temperature. Which theorist's work is the nurse practicing in this example? 1. Henderson 2. Orem 3. King 4. Nightingale

Nigntingale

informed consent (RN role)

Nurses need to know the law in their states and be familiar with the policies and procedures of their employing agency regarding consent

Who is responsible for obtaining informed consent?

Nurses witness consent; they do not obtain consent for procedures performed by others. The nurse's signature as a witness to the consent means that the patient appeared to voluntarily give consent, he or she appeared capable to give consent, and that the patient signed the consent in the nurse's presence.

Research process compared to nursing process

Nursing Process / Research Process Assessment/ Identify area of interest or clinical problem Diagnosis /Develop research question(s)/hypotheses Planning/Determine how study will be conducted Implementation/Conduct the study Evaluation/Analyze results of the study

Nursing student (Patient informed consent)

Nursing students cannot and should not be responsible for or asked to witness consent forms because of the legal nature of the document.

What is the relatiosnhsip between nursing theory and nursing research?

Nursing theory and nursing research build the knowledge base for nursing, which is then applied to practice. Theory-generating or theory-testing research refines the knowledge base of nursing. ◦Theory-generating uses logic to explore relationships among phenomena. ◦Theory-testing determines how accurately a theory describes a nursing phenomenon.

Which of the following statements related to theory-based nursing practice are correct? (Select all that apply.) 1. Nursing theory differentiates nursing from other disciplines. 2. Nursing theories are standardized and do not change over time. 3. Integrating theory into practice promotes coordinated care delivery. 4. Nursing knowledge is generated by theory. 5. The theory of nursing process is used in planning patient care. 6. Evidence-based practice results from theory-testing research.

Nursing theory differentiates nursing from other disciplines. Integrating theory into practice promotes coordinated care delivery. Nursing knowledge is generated by theory.

Developing a PICOT

P = Patient population of interest Identify patients by age, gender, ethnicity, and disease or health problem. I = Intervention or area of interest Which intervention is worthwhile to use in practice (e.g., a treatment, diagnostic test, prognostic factor)? What area of interest influences a desired outcome (e.g., complementary therapy, motivational interviewing). C = Comparison intervention or area of interest What is the usual standard of care or current intervention used now in practice? O = Outcome What result do you wish to achieve or observe as a result of an intervention (e.g., change in patient behavior, physical finding, or patient perception)? T = Time What amount of time is needed for an intervention to achieve an outcome (e.g., the amount of time needed to change quality of life or patient behavior)?

Nursing: Caring for self strategies

Personal strategies: •Health-promoting behaviors •Healthy lifestyle choices •Develop coping skills, allow personal time for grieving, focus on spiritual health •Find a mentor or experience nurse to help Health care organizations: •Offer educational programs •Debriefing sessions •Support groups •Mental health assistance

A nurse received bedside report at the change of shift with the night-shift nurse and the patient. The nursing student assigned to 320the patient asks to review the patient's medical record. The nurse lists patients' medical diagnoses on the message boards in the patients' rooms. Later in the day the nurse discusses the plan of care for a patient who is dying with the patient's family. Which of these actions describes a violation of the Health Insurance Portability and Accountability Act (HIPAA)? 1. Discussing patient conditions at the bedside at the change of shift 2. Allowing the nursing student to review the assigned patient's chart before providing care during the clinical experience 3. Posting medical information about the patient on a message board in the patient's room 4. Releasing patient information regarding terminal illness to family when the patient has given permission for information to be shared

Posting medical information about the patient on a message board in the patient's room

Ask a clinical question in PICOT format.

Problem-focused trigger Knowledge-focused trigger Developing a PICOT question: P = Patient population of interest I = Intervention of interest C = Comparison of interest O = Outcome T = Time

The nurse is using the QSEN competency of EBP when working with the unit council to initiate a change related to pain management. Which behaviors demonstrate the nurse practicing behaviors associated with EBP? (Select all that apply.) 1. Initiating plan for self-development as a team member 2. Reading original research related to pain management 3. Demonstrating effective use of strategies to reduce risk of harm to self or others 4. Valuing EBP as critical to the development of pain management guidelines for the unit 5. Describing to the unit council reliable sources for locating clinical guidelines 6. Applying technology and information management tools to support safe processes of care

Reading original research related to pain management Valuing EBP as critical to the development of pain management guidelines for the unit Describing to the unit council reliable sources for locating clinical guidelines

Which of the following actions, if performed by a registered nurse, could result in both criminal and administrative law sanctions against the nurse? (Select all that apply.) 1. Reviewing the electronic health record of a family member who is a patient in the same hospital on a different unit 2. Refusing to provide health care information to a patient's child 3. Reporting suspected abuse and neglect of children 4. Applying physical restraints without a written order 5. Completing an occurrence report on the unit

Reviewing the electronic health record of a family member who is a patient in the same hospital on a different unit Applying physical restraints without a written order

A nurse is caring for a patient who recently lost a leg in a motor vehicle accident. The nurse best assists the patient to cope with this situation by applying which of the following theories? 1. Roy 2. Watson 3. Johnson 4. Benner

Roy

informed consent (Language barriers: deaf, illiterate, or speaks a foreign language)

Special consideration is used when a patient is deaf, illiterate, or speaks a foreign language. A professional interpreter must be present in person or remotely to explain the terms of consent.

Standard of Practice

Standards of nursing care reflect the knowledge and skill ordinarily possessed and used by nurses . Standards of nursing care are derived from health care laws, best practice guidelines, professional organization white papers, evidence-based nursing knowledge, and citizen advocacy groups.

A nurse is planning care for a patient going to surgery. Who is responsible for informing the patient about the surgery along with possible risks, complications, and benefits? 1. Family member 2. Surgeon 3. Nurse 4. Nurse manager

Surgeon

Critically appraise the evidence.

Synthesize or combine the findings Consider the scientific rigor of the evidence and whether it has application in practice

A nurse sends a text message to the oncoming nurse to report that a patient refuses to take medication as ordered. What should the oncoming nurse do? (Select all that apply). 1. Add this information to the board hanging at the patient's bedside. 2. Tell the nurse who sent the text that the text is a HIPAA violation. 3. Inform the nursing supervisor. 4. Forward the text to the charge nurse. 5. Thank the nurse for sending the information.

Tell the nurse who sent the text that the text is a HIPAA violation. Inform the nursing supervisor.

Best ways to prevent claims of negligence

The best way for nurses to avoid malpractice is to follow evidence-based standards of care, deliver care competently, and communicate with other health care providers. You also avoid malpractice by developing a caring rapport with patients and thoroughly documenting assessments, interventions, and evaluation of care. Generate and act on your spirit of inquiry to provide the best care in conjunction with your patients' preferences and values.

. The nurse is working in an agency that has recently implemented an electronic health record. Which of the following are acceptable practices for maintaining the security and confidentiality of electronic health record information? (Select all that apply.) 1. Using a strong password and changing your password frequently according to agency policy 2. Allowing a temporary staff member to use your computer user name and password to access the electronic record 3. Ensuring that work lists (and any other data that must be printed from the electronic health record) are protected throughout the shift and disposed of in a locked receptacle designated for documents that are to be shredded when no longer needed 4. Ensuring that the patient information that is displayed on the computer monitor that you are using is not visible to visitors and other health care providers who are not involved in that patient's care 5. Remaining logged in to a computer to save time if you only need to step away to administer a medication

Using a strong password and changing your password frequently according to agency policy Ensuring that work lists (and any other data that must be printed from the electronic health record) are protected throughout the shift and disposed of in a locked receptacle designated for documents that are to be shredded when no longer needed Ensuring that the patient information that is displayed on the computer monitor that you are using is not visible to visitors and other health care providers who are not involved in that patient's care

Evaluate the outcomes of practice decision or changes.

When evaluating an EBP change determine: -Was the change effective? -Are modifications needed? -Should the change be discontinued?

The importance of self-care for nurses

You cannot give fully engaged, compassionate care to others when you feel depleted or do not feel cared for yourself. You and your colleagues will have many self-care needs that must be met to function as healthy professionals. In your educational experience and in your career, you will experience grief and loss. Many times, even before you have a chance to recover from an emotionally draining situation, you will encounter another difficult human story.

paradigm

a pattern of beliefs used to describe the domain of a discipline. It links the concepts, theories, beliefs, values, and assumptions accepted and applied by the discipline

concepts

a thought or idea of reality that is put into words or phrases to help describe or explain a specific phenomenon. Concepts can be abstract such as emotions or concrete such as physical objects

General Adaptation Syndrome (GAS)

a three-stage set of physiological processes that prepare, or adapt, the body for danger so that an individual is more likely to survive when faced with a threat 1) initial alarm, (2) resistance as a person attempts to compensate for changes induced by the alarm stage, and (3) a state of exhaustion if the person cannot adapt successfully during the stage of resistance or if stress remains unrelieved.

grand theory

abstract, broad in scope, and complex; therefore they require further clarification through research so that they can be applied to nursing practice. A grand theory does not provide guidance for specific nursing interventions.

Quasi-intentional torts

acts in which a person may not intend to cause harm to another but does. Quasi-intentional torts are alleged when a person should have known that harm to another person could occur.

Prescriptive theories

address nursing interventions for a phenomenon, guide practice change, and predict the consequences. Prescriptive theories direct nursing actions toward an explicit goal.

nursing metaparadigm a

allows nurses to understand and explain what nursing is, what nursing does, and why nurses do what they do (person, health, environment/situation, nursing)

resistance stage

also contributes to the fight-or-flight response, and the body stabilizes and responds in an attempt to compensate for the changes induced by the alarm stage. Hormone levels, heart rate, blood pressure, and cardiac output should return to normal, and the body tries to repair any damage that occurred. However, these compensation attempts consume energy and other bodily resources.

Practice theory

also known as situation-specific theories, bring theory to the bedside. Narrow in scope and focus, these theories guide the nursing care of a specific patient population at a specific time

Middle-range theories

are more limited in scope and less abstract. They address a specific phenomenon and reflect practice (administration, clinical, or teaching). middle-range theories expand on specific concepts or phenomena in a specific field of nursing such as uncertainty, incontinence, social support, quality of life, and caring.

Descriptive theories

are the first level of theory development.Descriptive theories do not direct specific nursing activities or attempt to produce change but rather help to explain patient assessments.

What is the purpose of the Nurse Practice Act (NPA)?

civil state (statutory) law that defines nursing and the standards that must be met (state specific)

Torts

civil wrongful acts or omissions made against a person or property.

evidence-based practice

guides nurses and other health care providers in making effective, timely, and appropriate clinical decisions. EBP is a problem-solving approach to clinical practice that combines the deliberate and systematic use of best evidence in combination with a clinician's expertise, patient preferences and values, and available health care resources in making decisions about patient care.

health

has different meanings for each patient, the clinical setting, and the health care profession. It is a state of being that people define in relation to their own values, personality, and lifestyle.

outcomes research

helps patients, health care providers, and those in health care policy make informed decisions based on current evidence. Outcomes research typically focuses on the benefits, risks, costs, and holistic effects of a treatment on patients.

nursing

includes "care of individuals of all ages, families, groups and communities, sick or well and in all settings. Nursing includes the promotion of health, prevention of illness, and the care of ill, disabled and dying people"

environment/situation

includes all possible conditions affecting patients and the settings where they go for their health care.

Nursing Theory

is a conceptualization of some aspect of nursing that describes, explains, predicts, prescribes nursing care

peer-reviewed article

is reviewed for accuracy, validity, and rigor and approved for publication by experts before it is published. MEDLINE and the Cumulative Index of Nursing and Allied Health Literature (CINAHL) are among the best-known online databases for scientific knowledge in health care

Participants approval: informed consent

means that research subjects (1) are given full and complete information about the purpose of a study, procedures, data collection, potential harm and benefits, and alternative methods of treatment; (2) are capable of fully understanding the research and the implications of participation; (3) have the power of free choice to voluntarily consent or decline participation in the research; and (4) understand how the researcher maintains confidentiality or anonymity.

Nursing students - employed in a health care setting

must perform tasks delegated to them AND in the titled job description

Lateral voice

occurs in nurse-nurse interactions; includes withholding information, making snide remarks, demonstrating nonverbal expressions of disapproval

Burnout

occurs when perceived demands outweigh perceived resources; state of physical and mental exhaustion; stems from conflicts/satisfaction within work setting

Administrative Law

or regulatory law, more clearly defines expectations of civil and criminal laws. egulations typically state that duty means you will observe, assess, diagnose, plan, intervene, and evaluate patient care. Regulatory law also describes the process to report incompetent or unethical nursing conduct to the State Board of Nursing or Nursing Commission.

EMTALA (Emergency Medical Treatment and Active Labor Act)

prohibits the transfer of patients from private to public hospitals without appropriate screening and stabilization. It is intended to prevent what is referred to as patient dumping. This act ensures that when patients come to the emergency department or the hospital, an appropriate medical screening occurs.

HIPPA (Health Insurance Portability and Accountability Act)

provides rights to patients and protects employees. HIPAA established a patient's right to consent to the use and disclosure of protected health information, to inspect and copy one's medical record, and to amend mistaken or incomplete information

Bias

refers to effects that a conclusion that may be incorrect

Theory-testing

research determines how accurately a theory describes a nursing phenomenon. Testing develops the evidence for describing or predicting patient outcomes

Theory-generating

research uses logic to explore relationships among phenomena. In theory-generating research an investigator makes observations (without any preconceived ideas) to view a phenomenon in a new way.

assumptions

the "taken-for-granted" statements that explain the nature of the concepts, definitions, purpose, relationships, and structure of a theory. Assumptions are accepted as truths and are based on values and beliefs.

alarm stage

the central nervous system is aroused, and body defenses are mobilized; this is the fight-or-flight response. During this stage rising hormone levels result in increased blood volume, blood glucose levels, epinephrine and norepinephrine, heart rate, blood flow to muscles, oxygen intake, and mental alertness.

Valdity

the extent to which a test measures or predicts what it is supposed to

Reliability

the extent to which a test yields consistent results, as assessed by the consistency of scores on two halves of the test, on alternate forms of the test, or on retesting

domain

the perspective or territory of a profession or discipline. It provides the subject, central concepts, values and beliefs, phenomena of interest, and central problems of a discipline.

person

the recipient of nursing care, including individual patients, groups, families, and communities. The person is central to the nursing care you provide.

phenomenon

the term, description, or label given to describe an idea or responses about an event, a situation, a process, a group of events, or a group of situations

Secondary traumatic stress

trauma that health care providers experience when witnessing and caring for others suffering trauma

Standard of Proof - "reasonably prudent"

typically what a reasonably prudent nurse would do under similar circumstances in the geographic area in which the alleged breach occurred.

Purpose of a health care record

•Facilitate interprofessional communication among health care providers •Legal record of care provided •Justification for financial billing and reimbursement of care •Auditing, monitoring, and evaluation of care provided •Education and research

quantative research

•Studies phenomena that are difficult to quantify or categorize, such as perceptions of illness or quality of life. •Describes information obtained in nonnumeric form. •Aim is to understand patients' experiences with health problems and the contexts in which the experiences occur. •Involves inductive reasoning to develop generalizations or theories from specific observations or interviews. •Common methods: ethnography, phenomenology, grounded theory

Quantitative Research

•The precise, systematic, objective examination of specific concepts. •Focuses on numerical data, statistical analysis and controls to eliminate bias in findings. •Common methods: experimental, nonexperimental, survey, and evaluation

Grand Theory: Nightingale's Environmental Theory

◦Environment as the focus of nursing care ◦Environment manipulated so that nature can restore a patient to health ◦Taught and used the nursing process