RNSG 1309: Chapter 1
Code of Ethics
-ideals of right and wrong that define the principles you will use to provide care to your patients -It is important for you to incorporate your own values and ethics into your practice. -Ask yourself: How do your ethics, values, and practice compare with established standards
ANA Standards of Practice
Nursing is the foundation of clinical decision making**and includes all significant actions taken by nurses in providing care to patients, critical thinking known as the nursing process: -assessment -diagnosis -outcomes identification -planning -implementation -evaluation
Standards of Practice: Diagnosis
analyzing the assessed data to determine issue
Standards of Professional Practice: Education
attaining knowledge and competency that reflects current nursing practice
Novice
beginning nursing student with no previous experience and learns with sets of rules or procedures
Standards of Practice: collaboration
collaboration with health care consumers, families, and others in the conduct of nursing practice
Standards of Practice: Assessment
collecting comprehensive data pertinent to the patients health or situation
Standards of Practice: communication
communicates effectively in all areas of practice
Standards of Practice: Quality of Practice
contribution of quality nursing practice
Standards of Practice: leadership
demonstration of leadership in the professional practice setting and profession
Standards of Practice: professional practice evaluation
evaluation of ones-selves nursing practice in relation to professional practice standards
Standards of Practice: Evaluation
evaluation of progress toward attainment of outcomes
Standards of Practice: Outcomes Identification
identification of expected outcome for a plan individualized to the patient situation
Standards of Practice: Implementation
implementation of plan -coordination of care -health teaching & health promotion -consultation (the graduate lvl prepared specialty nurse or APRN provides consultation to influence plan, enhance abilities of others, and effect change) -prescriptive authority & treatment (the APRN uses prescriptive authority, procedures, referrals, treatment and therapies in accordance w laws)
Standards of Practice: Evidenced based Practice and Research
integration of evidence research findings into practice
Contemporary Care Influences
multiple external forces and changes in society that effect nursing: -need for nurses self care -Affordable Care Act -rising health care costs -changes in population -human rights -increasing numbers of medically underserved
Nursing requirements
nursing requires a blend of -current knowledge -practice standards -insightful & compassionate approach -critical thinking when it comes to patient care
Standards of Practice: environmental health
practicing in environmentally safe and healthy manner
Standards of Professional Practice: Ethics
practicing nursing ethically
Nurse Administrators
-manages patient care and delivery of specific nursing services within a healthcare agency -begins w positions such as clinical care coordinators -usually require at least a baccalaureate degree in nursing and a masters in nurse admin, hospital admin, or public health -needs to be skilled in business and management and understand all aspects in nursing and patient care -functions include budgeting, staffing, strategic planning of programs and services, & employee evals and development
Genomics
-newer term that describes the study of all genes in a person and interactions of these genes with one another and that persons environment -allows health care providers to determine how _____ changes contribute to patient conditions and treatment decisions
Importance of Nurses Self Care
-nurses need to be self -aware allowing them to identify their own vulnerability to secondary traumatic stress (caring for someone suffering from trauma) and burnout (physical & mental exhaustion) -participating in health promotion activities and managing stressors that lead to compassion fatigue help
Licensure & Certification
-required to pass the NCLEX-RN -certification requirements vary
Scope of practice
-rules of operation -tells us what we can and can't do -set skills by the American nurse association governed by the Board -provide safe patient care -box on pg 2 go over
Demographic Changes
-to effectively meet health care needs of the expanding and aging population changes need to occur as to how care is provided, especially in areas of outpatient, community, and home based services
Medically Undeserved
-unemployment, underemployment, low paying jobs, metal illness, homelessness, and rising healthcare costs all contribute to increases in ______ _________ population.
Impact of Emerging Technologies
-use technology to facilitate mobility, communications, and relationships (video conferencing, simulations) -develop an expertise to acquire and distribute knowledge (evidenced based practice, clinical decision support systems) -understand and use genomics
Nurse educator
-works primarily in schools of nursing, staff development departments of health care agencies, and patient education departments -responsible for teaching current nursing practice, trends, theory, and necessary skills in classrooms, labs, and clinical settings -masters or doctorate in nursing and have specific clinical, administrative, or research specialty and advanced clinical experience -participate in development of procedures and policies
Evidence based practice
-your practice needs to be based on current evidence, not just according to your education and experiences -by implementing this type of practice, you reduce health care errors and promote patient safety
Advanced degrees
Nurse practitioner... midwife...aprn...nurse educators
Health Care Advocates
Groups that recognize the importance of the role quality professional nursing has on the nations health care &prepare professional workforce to meet health promotion, illness prevention, and complex care needs of the population in a changing healthcare system -Robert Wood Johnson Foundation: Future of nursing campaign for action -Institute of Medicine: the future of nursing
1960: Documentation began
-ANA defined the scope of nursing and developed the Standards of Practice and Standards of Professional performance -these guide nurses to make significant and visible contributions that improve the health and well-being of individuals, communities, and populations -The goal is to improve the health and well-being of all individuals, communities, and populations through the significant and visible contributions of registered nursing using standards-based practice
Certified Registered Nurse Anesthetist (CRNA)
-APRN -advanced education from a nurse anesthesia accredited program -must have at least 1 year of critical care or emergency experience in order to apply to a program -provide surgical anesthesia under the guidance and supervision of the anesthesiologist
Certified Nurse Midwife (CNM)
-APRN -educated in midwifery and certified by the American College of Nurse Midwifery -involves providing indep. care for women during normal pregnancy, labor, and delivery and care for the newborn -includes gynecological services, pap smears, family planning and treating vaginal infections
clinical nurse specialist (CNS)
-APRN -expert clinician in a specialized area of practice -specialty identified by a population(geriatrics) -specialty identified by a setting(critical care) -a disease specialty(diabetes) -a type of care(rehab) -a type of problem(pain) EX: community, acute care, restorative care, palliative
nurse practitioner (NP)
-APRN -provides health care to a group of patients like outpatients, ambulatory care, or community-based setting -provides care to complex patients with chronic or healthy conditions with more holistic approaches -est. a provider-patient relationship and works w specific group of patients or w patients of all ages and health care needs
Professional Nursing Organizations
-Address member concerns -Present educational programs -Publish journals -Student organizations National Student Nurses Association (NSNA) Canadian Student Nurses Association (CSNA)
Twenty-First Century
-Changes in curriculum -Advances in technology and informatics -New programs address current health concerns -Leadership role in developing standards and policies
Civil War to the Beginning of the Twentieth Century
-Clara Barton: founder of American red cross, cleansed and tended to wounded soldiers in battle -Mother Bickerdyke: organized ambulances and walked the battlefield at night looking or wounded soldiers -Harriet Tubman: active in the underground railroad movement and lead 300 slaves to freedom -Mary Mahoney: first professionally trained African American nurse and brought forth awareness of culture diversity in healthcare setting -Lillian Wald & Mary Brewster: opened Henry Street Settlement which focused on health needs of poor ppl in late 20th century
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
Florence Nightingale
-First practicing epidemiologist -Organized first school of nursing -est. first nursing philosophy based on health management and restoration -Improved sanitation in battlefield hospitals -Practices remain a basic part of nursing today
The Twentieth Century
-Movement toward scientific, research-based practice and defined body of knowledge -Nurses assumed expanded and advanced practice roles *1906: Mary Adelaide Nutting, first nursing professor at Columbia Teacher's College *Army and Navy Nurse Corps established *1920s: Nursing specialization began
Career Development
-Nursing provides an opportunity for you to commit to lifelong learning and career development
Nursing Practice Acts
-Overseen by State Boards of Nursing -Regulate scope of nursing practice -Protect public health, safety, and welfare
History of Nursing
-Respond to needs of patients -Actively participate in determining best practices -Knowledge of the history of the nursing profession increases your ability to understand the social and intellectual origins of the discipline.
Competent
-a nurse that has been in the same clinical position for 2-3 years -understands the organization and specific care required for patients -able to participate in nursing care and can establish long-term goals -has experience with psychomotor skills required for specific patient groups
Expert
-a nurse with diverse experience -can zero in on the problem and focus on multiple dimensions of the situation -interpret clinical situations and make complex decisions -skilled at identifying both patient-centered problems and problems related to the health care system or needs of novice nurse
Proficient
-a nurse with more than 2-3 years of experience in the same clinical position -perceives the patient clinical situation as a whole -assess a entire situation -readily transfer knowledge from multiple previous situations -focuses on managing care as opposed to managing and performing skills
Advanced Beginner
-a nurse with some level of experience with the situation -experience may be observational in nature but she can still apply and identify meaningful aspects or principals of nursing care
Quality and Safety Education for Nurses
-addresses the challenge to prepare nurses with the competencies needed to continuously improve the quality of care in work environments -competencies of patient centered care, teamwork and collaboration, evidenced based practice, quality improvement, safety, informantics
Patient Centered Care & Professionalism
-administer quality care in a safe, prudent and knowledgeable manner -be responsible and accountable for yourself, patients, & peers
Nurse Researcher
-conducts evidence based practice and research to improve nursing care and further define and expand the scope of nursing practice -preferred doctorate degree w at least a masters in nursing
Affordable Care Act
-effects how health care is paid for and delivered -impacts how and where nursing care is provided -use health care and patient resources wisely
Standards of Practice: resources
the use of appropriate resources to plan and provide nursing services that are safe, effective, and financially responsible
Benner's Stages
an expert passes through the five levels of proficiency when acquiring and developing generalist or specialized nursing skills The five stages include: -novice -advanced beginner -competent -proficient -expert
Standards of practice
Foundation of clinical decision making
Professional RN Education
Registered nurse education 2-year associate's degree 4-year baccalaureate degree Graduate education Master's degree, advanced practice RN Doctoral degrees
Clinical nurse specialist
Specialty is based on type of settings
Nursing shortages
With fewer available nurses, it is important for you to learn to use your patient contact time efficiently and professionally by using the following essential skills: -Time management -Therapeutic communication -Patient education -Compassionate implementation of bedside skills
International Council of Nursing (ICN) definition of Nursing
_________ encompasses autonomous and collaborative care of individuals of all ages, families, groups, and communities, sick or well, and in all settings. ________ includes the promotion of health; prevention of illness; and the care of the ill, disabled, and dying. Advocacy, promotion of a safe environment, research, participation in shaping health policy in patient and health systems management, and education are key roles in nursing
American Nurses Association (ANA) definition of Nursing
__________ is the protection, promotion, and optimization of health and abilities; prevention of illness and injury; alleviation of suffering through the diagnosis and treatment of human response; and advocacy in the care of individuals, families, communities and populations
Standards of Practice: Planning
developing a plan that prescribes strategies and alternatives to attain expected outcomes
ANA Standards of Professional Performance
methods to assure patients they are receiving the highest quality care, nurses must know exactly what is necessary to provide nursing care, and measures are in place to assure standards are met -ethics -education -evidence based practice & research -quality of practice -communication -leadership -collaboration -professional practice evaluation -resources -environmental help
Advanced Practice Registered Nurse (APRN)
most indep. functioning nurse that has advanced education in pathophysiology, pharmacology, and physical assessment. certification, and expertise in a specialized area -clinical nurse specialist -nurse practitioner -certified nurse midwife -certified registered nurse anesthetist
