Ch. 20 & Ch. 26

Nursing roles

(1) Traditional duties and responsibilities of the professional nurse, regardless of practice area or setting, such as the roles of care provider, educator, counselor, client advocate, change agent, leader and manager, researcher, and coordinator of the interprofessional health care team. (2) Duties and responsibilities of the professional nurse that are guided by specific professional standards of practice and usually carried out in a distinct practice area (e.g. flight nurse, forensic nurse, occupational nurse)

COMPARING clinical practice guidelines and clinical pathways

A clinical practice guideline would be used to determine if a patient diagnosed with prostate cancer should undergo radiation treatment based on his specific cancer diagnosis, age, and other comorbidities. The clinical pathway would guide the care provided to a cancer patient currently undergoing radiation therapy

Nursing care delivery model

Also called CARE DELIVERY SYSTEM or PATIENT CARE DELIVERY MODEL; details the way work assignments, responsibility and authority are structured to accomplish patient care; depicts which health care worker is going to perform what tasks, who is responsible, and who has the authority to make decisions.

Clinical Pathways

Also called CRITICAL PATHS, PRACTICE PROTOCOLS, PATIENT CARE PROTOCOLS, or CARE MAPS, are clinical management plans that specify major patient care activities and interprofessional interventions and desired outcomes within a specified time period for a particular diagnosis or health condition. The advantage of the clinical pathway is that is provides a means of standardizing care for patient with similar diagnoses and defines key processes and patient goals in the day-to-day management of care.

Unlicensed assistive personnel (UAP)

An unlicensed individual who is trained to function in an assistive role to the RN by performing patient care activities as delegated by the nurse; may include nursing assistants, clinical assistants, orderlies, health aides, or other titles designated within the work setting

Nursing Educator

Assume leadership in curriculum development, instruction, and evaluation.

Primary Nursing Model

Assumes 24-hr responsibility for planning, directing, and evaluating the patients care from admission through discharge

Advanced practice nursing

Based on knowledge and skills acquired through basic nursing education, with licensure as a registered nurse (RN) and graduate education and experience that includes advanced nursing theory, physical assessment, psychosocial assessment, and treatment of illness. Includes nurse practitioners (NPs), certified nurse-midwives (CNMs), certified registered nurse anesthetists (CRNAs), and clinical nurse specialist (CNSs).

Staff mix

Combination of categories of workers employed to provide patient care (e.g. RNs, LPNs, or licensed vocational nurses [LVNs], or unlicensed assistive personnel [UAP]).

Case Manager

Coordinate resources to achieve health care outcomes based on quality, access, and cost. Identify the nest resources at the lowest cost to achieve the optimal health outcome for the client.

Staffing

Ensuring that an adequate number and mix of health care team members (e.g. RNs, LPNs or LVNs, UAP, clerical support) are available to provide safe, quality patient care; usually a primary responsibility of the NURSE MANAGER

Informatics Nurse specialist

Focuses on management and processing of health care information.

Interprofessional team

Health care team composed of professionals from different disciplines including chaplains, nurses, dieticians, pharmacists, physical therapists, physicians, respiratory therapists, social workers, and speech-language pathologist who cooperate, collaborate, communicate, and integrate care to ensure that care is continuous and reliable.

Leader

Improving the health status and potential of individuals or families. Ensuring that safe, high-quality care is provided across all health care settings. Increasing the effectiveness and level of satisfaction among professional colleagues providing care. Managing multiple resources in a health care facility. Elevating citizen's and legislators' attitudes toward and expectations of the nursing profession and the health care system.

Total Patient Care Model

In total patient care, nurses are responsible for planning, organizing, and performing all care, including personal hygiene, medications, treatments, emotional support, and education required for their assigned group of patients during the assigned SHIFT.

Patient acuity

Indication of the amount and complexity of care required for any particular patient; high acuity indicates a need for more intense, complex nursing care as compared with lower acuity, which indicates a need for moderate, less complex nursing care

Coordinator of the Interprofessional Health Care Team

Interprofessional teams consist of a collaborative practice relationships among several disciplines of health care professionals.

Case Management

Is a model of care delivery in which the RN case manager coordinates the patients care throughout the course of an illness. Nursing case management is defined as a "dynamic and systematic collaborative approach to provide and coordinate health care services to a defined population. The framework for nursing case management includes five components: Assessment, Planning, Implementation, Evaluation, and Interaction. The GOAL of case management is to focus attention on the quality, outcomes, and cost of care throughout the patients episode of illness and to assist the patient to move through the continuum of care

Patient classification system

Method used to group or categorize patient according to specific criteria and care requirements and thus help quantify the patient acuity, or amount and level of nursing care needed.

Infection Control

Nurses assess the total incidence of infections within the hospital

Counselor

Nurses encourage clients to look at alternatives, recognize their choices, and develop a sense of control in a rapidly changing health care environment.

Flight nurse

Nurses who desire autonomous practice and the opportunity to use advanced clinical skills.

Manager

Nursing management includes planning, giving direction, and monitoring and evaluating nursing care of individuals, groups, families, and communities

Forensic Nurse

Nursing that applies nursing science to public or legal proceedings in the scientific investigation and treatment of trauma and/or death of victims of violence, abuse, criminal activity, and traumatic accidents

Client Advocate

Promoting what is best for the client, ensuring that the clients needs are met, and protecting the clients rights remain important responsibilities of the professional nurse

Patient-centered care

Providing care that is respectful of and responsive to individual patient preferences, needs, and values and ensuring that patient values guide all clinical decision

Clinical practice guidelines

Recommendations for appropriate treatment and care for specific clinical circumstances; guidelines are developed though a systematic process to integrate the nest evidence for treating specific medical conditions and assist health care providers to make decisions about appropriate treatment

Parish Nurse

Role focuses on health promotion within the beliefs, values, and practices of various faith communities. In these contexts, health is seen as a sense of physical, psychological, social, and spiritual well-being.

School nurse

School health manager or coordinator and includes functions, such as policymaking, case management and program management activities, and health promotion and protection activities.

Partnership Model

Sometimes referred to as COPRIMARY NURSING, is a modification of primary nursing. This model was designed to make more efficient use of the RN, who delegates nonprofessional tasks to the partner, thus providing more time for the RN to address professional demands, such as assessment and patient education. In the partnership model, the RN is partnered with an LVN, LPN, or UAP, and the pair work together consistently to care for an assigned group of patients

Functional Nursing Model

Staff members are assigned to complete certain tasks for a group of patients rather than care for specific patients. For example, the RN performs all assessments and care planning, and administers all intravenous medications, the LVN or LPN gives all oral medications; and the assistant performs hygiene tasks and takes vital signs. A charge nurse makes the assignments and coordinates the care

Hospice Nurse

Terminally ill patients are treated to maximize quality of life rather than focus on the quantity of life remaining

PhD

That prepares individuals for a research career.

Clinical nurse leader (CNL)

The CNL is a master's degree-prepared generalist who oversees the care coordination of a distinct group of patients in any setting. The CNL actively provides direct patient care in complex situations, evaluates patient outcomes, and has the decision-making authority to change care plans when necessary. This clinician puts EVIDENCE-BASED PRACTICE into action to ensure that patients benefit from the latest innovations in care delivery and is envisioned as a leader in the health care delivery system.

Doctor of nursing practice (DNP)

The DNP is an expert in advanced nursing practice who has an earned clinically focused doctorate degree in nursing

Team Nursing Model

The RN functions as a team leader and coordinates a small group (generally no more than four or five) of ancillary personnel to provide care to a small group of patients

Occupational health opportunities

The nurse designs and implements a program of health promotion and disease prevention for employees and assists with immediate health needs as necessary.

Change Agent

The profession continues to identify client, patient safety, and health care delivery problems; assess individual and organizational motivation and capacity for change; to determine alternatives; to explore possible outcomes of the alternatives; and to assess cost-effective resources in infinite health-related situations.

Care provider

Thenurse assess client resources, strengths and weakness, coping behaviors, and the environment to optimize the problem-solving and self-care abilities of the client and family.

Researcher

These nurses may be assisting with data collection, critiquing research findings, and using these findings in practice.

Quality Manager

This reflects the need for health care providers to assess opportunities for process improvement, implement changes, measure outcomes, and then start the improvement process over again.

Quality Management

To ensure that outcomes in client care services are consistent with established standards. Benchmarking activities to establish such standards have been under way on a national level for the past few decades.

Educator

Today the emphasis is on health promotion and health maintenance, in addition to management of disease conditions.

Telephone triage nurse (Telehealth nurse)

Uses technology to provide health services by various telecommunication tools.

Telehealth or telephone nursing

Using the nursing process to provide nursing care and access to health care for individual patients or patient populations over the telephone