Introduction to Medical Surgical Nursing

Communication & Collaboration

(Introduction) Situation, Background, Assessment, Recommendation

What is Medical Surgical Nursing?

- AKA: Adult Health Nursing - "Where nurses promote, restore, or maintain optimal health for patients from 18 years to older than 100" (Academy of Medical Surgical Nurses)

Where Do We Practice?

- Acute Care Facilities - Skilled Nursing Facilities - Home Care Agencies - Ambulatory Care Clinics

What is the Role of the Nurse?

- Care Coordinator - Caregiver - Patient Education - Patient & Family Advocate

Quality & Safety Education for Nurses (QSEN)

1. Provide patient centered care 2. Collaborate with the interdisciplinary team 3. Implement evidence -based practice 4. Use quality improvement in patient care 5. Use informatics 6. Safety

Here is the Reality

44,000-98,000 deaths resulting from preventable errors.(Institute of Medicine, 2000) According to the Joint Commission (2012) ineffective communication is the cause of 80% of medical errors in healthcare settings.

A nurse is caring for a postoperative patient on the surgical unit. The patient's blood pressure was 142/76 mm Hg 30 minutes ago, and now is 88/50 mm Hg. What action by the nurse is best? A. Call the Rapid Response Team. B. Document and continue to monitor. C. Notify the primary care provider. D. Repeat blood pressure measurement in 15 minutes.

A

Bedside computers are an example of informatics used in health care primarily for which purpose? A. Documenting interdisciplinary care B. Enhancing collaboration and coordination of care C. Offering clients access to e-mail and the Internet D. Retrieving data for evidence-based practice

A

What is the purpose of the Rapid Response Team? A. Provide Code Blue teams in case of simultaneous emergencies. B. Enable the nurse to recognize changes in patient status before an acute emergency. C. Replace immediate consultation with the physician or medical resident. D. Provide teams of staff already familiar with the patient's medical diagnosis.

A

Which important aspect of coordinating care within the interdisciplinary team is facilitated by use of the "SBAR" procedure? A. Communication B. Implementation C. Policymaking D. Protocol development

A

5. A client is going to be admitted for a scheduled surgical procedure. Which action does the nurse explain is the most important thing the client can do to protect against errors? a. Bring a list of all medications and what they are for. b. Keep the doctor's phone number by the telephone. c. Make sure all providers wash hands before entering the room. d. Write down the name of each caregiver who comes in the room.

A. Bring a list of all medications and what they are for

A new nurse is working with a preceptor on an inpatient medical-surgical unit. The preceptor advises the student that which is the priority when working as a professional nurse? A. Attending to holistic patient needs B. Ensuring patient safety C. Not making medication errors D. Providing patient-focused care

B

Which is the best way for the nurse to assess the patient's learning after teaching? A. Have the patient write a summary of the points covered. B. Ask the patient to repeat the information back. C. Quiz the patient on relevant points in the instruction. D. Repeat the important points to the patient.

B

Why Must Nurses Have a Broad Knowledge Base?

Rapid Advances in Technology Massive Increases in Available Knowledge Dramatic Changes in Healthcare Delivery

Delegation

Right Task Right Circumstance Right Person Right Communication Right Supervision

6. Which action by the nurse working with a client best demonstrates respect for autonomy? a. Asks if the client has questions before signing a consent b. Gives the client accurate information when questioned c. Keeps the promises made to the client and family d. Treats the client fairly compared to other clients

a. Asks if the client has questions before signing a consent

4. A nurse wishes to provide client-centered care in all interactions. Which action by the nurse best demonstrates this concept? a. Assesses for cultural influences affecting health care b. Ensures that all the clients' basic needs are met. c. Tells the client and family about all upcoming tests d. Thoroughly orients the client and family to the room

a. Assesses for cultural influences affecting health care

2. A nurse is orienting a new client and family to the inpatient unit. What information does the nurse provide to help the client promote his or her own safety? a. Encourage the client and family to be active partners. b. Have the client monitor hand hygiene in caregivers. c. OFer the family the opportunity to stay with the client. d. Tell the client to always wear his or her armband.

a. Encourage the client and family to be active partners.

A student nurse asks the faculty to explain best practices when communicating with a person from the lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ) community. What answer by the faculty is most accurate? a. Avoid embarrassing the client by asking questions. b. Don't make assumptions about their health needs. c. Most LGBTQ people do not want to share information. d. No diFerences exist in communicating with this population.

b. Don't make assumptions about their health needs.

Family Centered Care

https://www.youtube.com/watch?v=DBVuu4Qj-Fs http://www.jointcommission.org/multimedia/SpeakUp_Preparing_for_surgery/