Nurs 250 Exam 2

Model for EBP

-Assess: need for change/problem -Link: problem/interventions/outcome -Synthesize: look/critique/benefits/risks -Design: proposed change -Implement: pilot/evaluate/yes or no -Integrate/Maintain: practice

Human traits nurses are famous for

-Competence -Compassion -Trustworthiness -Conscientious -Intelligence -Courage - Integrity

what 4 things must be established to prove malpractice has occurred?

-DUTY: obligation to use due care -BREECH OF CARE: Failure to meet standard of care -CAUSATION: failure to meet standard caused injury - DAMAGES: harm caused to patient

What may help increase enrollment or production of students?

-Funding on state and federal levels is needed -Hospital funding with agreement for employment after graduation may help -Private foundation contributions

Why will the demand for nurses increases?

-Growing population -Advances in health care field requiring more RN's -Increased acuity of hospitalized patients -Growing #'s of elderly who need more nursing care -Increased life expectancy/chronic illnesses -Emphasis on PREVENTION

three main areas of patient advocacy

-REPRESENTING PATIENTS -PROMOTING SELF DETERMINATION -BEING POLITICALLY ACTIVE

What should impaired nurses with controlled substances do?

-Recognize self, colleague potential

Steps of Quantitative Research

1) State the research problem 2) Define the purpose of the study 3) Review related literature 4) Formulate hypotheses and variables 5) Select the research design 6) Select the population and sample 7) Collect the data 8) Analyze the data 9)Communicate findings and conclusions

Increases in the demand will grow ______ % each year

2-3

what is nursing informatics?

A specialty that integrates nursing science, computer science, and information science to manage and communicate data, information, knowledge, and wisdom in nursing practice.

The nurse attorney provides an educational session to the nursing staff on acts of negligence. Which responses by the staff would indicate to the attorney that the staff can accurately identify acts of negligence? Select all that apply. A. "I can be charged with negligence if I apply a heating pad to the client's skin and the client suffers a superficial or first-degree burn." B. "I can be charged with negligence if I follow the policy for administering insulin and the client has a reaction to it." C. "I can be charged with negligence if I am following the standards of care for my specialty, which is ambulatory nursing." D. "When I am using a new piece of equipment for the first time, I must make sure I know how to properly operate it." E. "I can be charged with negligence if I notify the health care practitioner about a change in a client's status but do not follow up or document.

A. "I can be charged with negligence if I apply a heating pad to the client's skin and the client suffers a superficial or first-degree burn." E. "I can be charged with negligence if I notify the health care practitioner about a change in a client's status but do not follow up or document.

A care team is made up of the nurse, LPN, and a UAP. Which client should be assigned to the nurse? A. A client diagnosed with (TSS) Toxic Shock Syndrome B. A client recovering from an ectopic pregnancy C. A client recovering from the removal of a hydatidiform mole. D. A client recovering from a vaginal hysterectomy

A. A client diagnosed with (TSS) Toxic Shock Syndrome

The nurse enters a client's room and observes that the client is hunched over and appears to be breathing rapidly. What type of question should the nurse first ask the client in this interaction? A. A yes or no question B. A directing question C. An open-ended question D. A reflective question

A. A yes or no question

During a clinical placement on a subacute, geriatric medicine unit, a student nurse fed a stroke client some beef broth, despite the fact that the client's diet was restricted to thickened fluids. As a result, the client aspirated and developed pneumonia. Which statement underlies the student's potential liability in this situation? A. The same standards of care that apply to a registered nurse apply to the student. B. The student and the nursing instructor share liability for this lapse in care. C. The client's primary nurse is liable for failing to ensure that delegated care was appropriate. D. The student's potential liability is likely negated by the insurance carried by the school of nursing.

A. The same standards of care that apply to a registered nurse apply to the student.

components of a research journal

Abstract Introduction Method Results Discussion References

Code of ethics developed by which orgs? What does it include?

American Nursing Association International Council of nursing Includes obligations, duties, and commitment to society

An informatics nurse is assisting with the development of a new clinical information system that will be implemented in the facility. As part of the process, the team is evaluating the purpose of the system and the technological options available. The team is in which phase of the system development lifecycle? Design Train Analyze and plan Test

Analyze and plan

principles of bioethics

Autonomy Nonmaleficence Beneficence Justice Fidelity

A client reports to a primary health care provider with aggravated chest pain. The health care provider prescribes a stress test. The client tells the nurse about not wanting to take the test and wanting to continue taking medication for now. Understanding that the client is anxious, which action should the nurse take first to provide education needed for this client? A. Instruct the client to find information about the test online. B. Ask the client "What has your health care provider shared with you about stress tests?" C. Provide the client with an educational booklet about stress tests. D. Tell the client about the stress test procedure.

B. Ask the client "What has your health care provider shared with you about stress tests?"

benefit the patient

Beneficence

A nurse finds that a client has infiltration around the IV line that needs to be removed. What explanation should the nurse give to reduce the client's anxiety? A. "This must have been caused from you moving your arm around." B. "Just be very still; the procedure is very minimal and will be over soon." C. "I know that you are anxious, but the IV location needs to be changed." D. "It will be a painless procedure and there is nothing to worry about; many clients experience this."

C. "I know that you are anxious, but the IV location needs to be changed."

The adult grandchild of a client with Parkinson's tells the nurse about a proposed B DAY gift for their grandparent. Which option is the best gift for the nurse to recommend? A. Perfume and makeup B. Hearing aid with batteries C. Warming tray for food D. Quilt and soft pillow

C. Warming tray for food

information

Data converted into a meaningful and useful context

DIKW

Data, Information, Knowledge, Wisdom

An informatics nurse specialist is working on a team that is considering a new technological system for the facility. Which aspect would be most important for the team to do as the first step? Train those who will be using the system Identify the use of standard terminology Determine the need or problem to be solved Conduct testing of the system

Determine the need or problem to be solved

EHR

EMR and MAR

elements of ethical agency?

Ethical sensibility Ethical responsiveness Ethical reasoning and discernment Ethical accountability Ethical character Ethical valuing Transformative ethical leadership

T or F: High levels of turnover are effective tools in maintaining organizational functioning and quality patient care.

False

T or F: New younger nurses are ideal prospects to act as expert mentors in specialty areas of a hospital.

False

A client rings the call bell to request pain medication. Upon performing the pain assessment, the nurse informs the client that she will return with the pain medication. The nurse's promise to return with the pain medication is an example of which principle of bioethics? Nonmaleficence Justice Autonomy Fidelity

Fidelity

•To encourage health care providers to give aid in emergency situations; protect them give care without fear

Good Samaritan laws

HITECH Act

Health Information Technology for Economic and Clinical Health Act

An informatics nurse specialist is recommending the addition of an alert system tool to the facility's patient portal. The tool would be designed to send alerts to the client to schedule routine screenings and immunizations. This recommendation most likely reflects which ANA informatics competency? Leadership Health teaching and health promotion Consultation Quality of practice

Health teaching and health promotion

Which of the following modes of value transmission is most likely to lead to confusion and conflict? Moralizing Modeling Responsible Choice Laissez-faire

Laissez-faire

Which of the following is not an ideal strategy to use to retain older nurses in the workforce? Benefit packages that recognize the needs of mature workers Use lift teams, special beds and equipment to reduce work related injuries and strains. Work redesign to limit physical energy expenditure Limit shift options to shorter shifts

Limit shift options to shorter shifts

avoid causing harm

Nonmaleficence

What does OSHA stand for?

Occupational Safety and Health Administration

OARS acronym

Open-ended questions Affirmation statements Reflection listening/statements Summarizing statements

A nurse has taken a telephone order from a physician for an emergency medication. The dose of the medication is abnormally high. What should the nurse do next? Question the order for the medication Document concerns about the order Administer the medication based on the order Refuse to administer the medication

Question the order for the medication

RULE acronym

Resist the righting reflex Understand patient motivation Listen to your patient Empower your patient

Which of the following factors have been identified as contributing to the cause of the current nursing shortage? High ceiling wages for RN's without advanced degrees. Decrease in the elderly population Selection of fields other than nursing as a career A relatively unhealthy economy of the late 1990's and early 2000's.

Selection of fields other than nursing as a career

SBAR

Situation Background Assessment Recommendation

•Interactions •Support/promotion of long-distance clinical health care

Telehealth

When making client rounds, the charge nurse observes which action by a staff nurse that would constitute battery? The staff nurse threatens to restrain the client if she did not take her medication. The elderly client refuses the intramuscular injection, but the staff nurse administered it. While bathing a client behind pulled curtains, two nurses are discussing a different client. The nurse tells the client she cannot leave the hospital because she is seriously ill.

The elderly client refuses the intramuscular injection, but the staff nurse administered it.

Which strategy could be implemented by the nurse in ensuring the protection of electronic data at health care agencies? The nurse locks out client information, except to those who have been authorized through appropriate security measures. The nurses are expected to change their access number and password less frequently. The nurse is being asked to remove the screen saver for data that have been displayed for prolong periods. The nurse gives unlimited access to the multidisciplinary team so that personnel from various departments can retrieve data.

The nurse locks out client information, except to those who have been authorized through appropriate security measures.

data is the .... in nursing

This data or base of knowledge is the rationale for "why we do what we do." This knowledge is the explanation for our nursing interventions

T or F: A free agent nurse makes a higher hourly wage than other full time or part time nurses in the health care organization.

True

T or F: Nursing informatics integrates nursing science and information science.

True

T or F: Patient outcomes are sensitive to nursing interventions and as a result, nursing staffing affects patient outcomes.

True

T or F: Rural areas of the country have a greater shortage of nurses than urban areas of the country.

True

a standard to help you determine how to behave; a belief that is meaningful and influences relationships you develop

VALUE

A nurse is caring for a client with hypertension whose blood pressure has increased from 154/78 mm Hg to 196/98 mm Hg with a heart rate of 110 beats per minute during the past hour. The nurse goes to lunch without reporting the change to the healthcare provider, and the client suffers a cardiac arrest. What principle has the nurse violated? a)Negligence b)Battery c)Veracity Fidelity

a)Negligence

•summary; data collection/analysis

abstract

•Program is evaluated and recognized as having met standards

accreditation

3 types of credentialing

accreditation, licensure, certification

The greatest shortage of nursing is seen in which of the following specialty areas? Assisted Living Care Acute Care Home Care Long Term Care

acute care

adjustment of living matter to other living things and environment

adaptation theory

empowered by executive officers; such as the board of nursing

administrative law

- have to be there ethically and morally for our patients

advocacy

protection and support of another's rights primary loyalty is to patient good of individual rather than good of society evaluate determination and well being of patient

advocacy

Who can write order depends on ...

agency policies

The nursing workforce its ______

aging

Functions of the electronic health record include which of the following? Provides communication among heath care team members Provides a single access point for health care providers managing care of a patient Provides a single location for long term data repository all of the above

all of the above

Which of the following explains why the demand for nurses is increasing? There is an increase in the acuity of hospitalized patients There is an increase in life expectancy as well as chronic illnesses. Advances in the health care field require more nurses all of the above

all of the above

-short staffed; help to same standards even when short staffed

allocation of resources

concern for well being of others understanding, advocacy

altruism

designed to improve clinical practice

applied research

Five "A"s of EBP

ask, acquire, analyze, apply, assess

threat/attempt to make bodily contact w/o consent

assault

examples of intentional tort

assault, battery, false imprisonment, defamation, invasion of privacy, fraud

knowledge that comes from an expert ( older nurse teaching bed making secrets!)

authoritative

respect rights of patients to make healthcare decisions. **Patient advocate

autonomy

•being independent -Helps patients to make decisions

autonomy

A nurse has been assigned to the ICU by her supervisor because there is an emergency there. However, the nurse is not aware of the setup and workings of the ICU. What would be the appropriate action by the nurse? a. to call the lawyer and seek her advice regarding the sudden change. b. to report to the nurse-in-charge for duty and tell her the tasks she can help with c. to report to the ICU and take leave on the pretext of some illness d. to refuse to go to the ICU and keep working in the previously assigned unit

b. to report to the nurse-in-charge for duty and tell her the tasks she can help with

•designed to refine a theory, and many times results are not useful in practice

basic research

quantitative methods =

basic research and applied research

carry out assault, with violent intent

battery

benefits of pt portals

better pt outcomes chronic illnesses keeps patients engaged retention proxy access

•the life sciences; human nature and behavior; genetics

bioethics

The client is a 40-year-old man admitted s/p repair of a femoral fracture. He discloses that he has a history of an addiction to painkillers and asks that the nurse assist him in adhering to his recovery from this addiction by not administering any narcotics. As the nurse reviews postoperative orders for the client, the nurse notes that his physician has ordered Codeine 30 mg p.o. q6 hours for pain. How does the nurse best approach this situation? a)Inform the next nurse that the client does not wish to receive narcotics. b)Offer the medication to the client; if he really doesn't want it, he will tell the nurse. c)Asks the physician to remove this order from the client's chart. d)Leave the order in the chart.

c)Asks the physician to remove this order from the client's chart.

A nurse is administering evening medications and notices that a medication was omitted during the day shift. Which statement demonstrates the principle of accountability? a)administering the medication with the other evening medications b)telling the client that the medication will be given the following morning c)filling out an occurrence report and notifying the health care provider d)documenting in the chart a narrative note about the occurrence

c)filling out an occurrence report and notifying the health care provider

Which of the following nursing situations is an example of an ethical dilemma? a.Administering Pain Medication as ordered b.Transferring a client to a step down unit c.Performing cardiac compressions when a signed DO NOT RESUSCITATE order (DNR) is not available d.Discussing care of a comatose patient with the family

c.Performing cardiac compressions when a signed DO NOT RESUSCITATE order (DNR) is not available

•Person meets criteria and is granted recognition in a specified practice area

certification

_____ law relates to the practice of nursing

civil

not sure of the meaning so you do this

clarifying

blocks to effective communication

cliches "why" questions being judgmental - opinionated changing the subject - uninterested false reassurance aggressiveness

•bedside; during the care of patients - Ill patients; n/p relationship; policy making, consents

clinical ethics

-Review policies, procedures

clinical resource

Who is payed more, those in academia or clinical staff?

clinical staff

•judiciary system reconciles controversies, creates body of common law

common law

Need to focus on what to get and keep nurses?

concentrate on recruitment, retention, and collaboration outreach campaign

•abstract impressions organized into symbols of reality -Conceptual framework or model

concepts

privacy of what patient tells you

confidentiality

serve as guides to legislative bodies

constitutions

•Promises between two parties •Nurse and facility/nurse and patient •What you expect of employer and what employer expects from you

contracts

What are components of a free agent nurse?

control their own hours agency, travel nurse, per diem (payed by day)

•Looking at relationship between two or more variables. •One may increase while other decreases •Both may increase or both may decrease

correlational

RN staffing turnover is ______ to health care institution

costly

-wrong against a person or his or her property as well as the public -Intent to commit wrong is present

crime

•concerns state and federal criminal statutes -Defines criminal actions, e.g., murder, theft

criminal law

facts and information; theoretical understanding of a particular subject.

data

info that is collected

data

shots/procedures; lying to comfort patient

deception

type of reasoning examines general ideas and considers specificactions or ideas

deductive reasoning

: derogatory remarks (slander is oral/libel is written)

defamation

•Consequences do not help determine if an action is RIGHT or WRONG.

deontologic

variable being studied, changes as a result of the study

dependent

•Describe events or occurrences in REAL LIFE; identifying relationships between and among events. •BEGINNING stages of research of topics

descriptive

•orderly and predictable growth and development

developmental theory

Purpose of Motivational Interviewing

discuss feelings, drive, and motivation of patient develop relationship identify problem and work towards solution

results with regard to purpose

discussion

characteristics of a helping relationship

dynamic - both participate purposeful - goals and time frame professional - accountable, responsible for outcomes

Negative effect of free agents on patient care

education level is satisfactory or above continuity or dedication to institution may be lacking

accepting responsibility for behavior

ethical accountability

The ability to do the ETHICALLY right thing because it is the right thing to do

ethical agency

-temperament and mood that allows one to act as they feel they should act.

ethical character

character and integrity

ethical character

•two or more clear moral principles apply but support mutually inconsistent courses of action

ethical dilemma

•the nurse knows the right thing to do but factors make it difficult to follow correct course of action

ethical distress

think through how to respond

ethical reasoning/discernment

willingness to respond to ethical challenge

ethical responsiveness

being able to recognize the ETHICAL MOMENT

ethical sensibility

system for right and wrong; professional conduct to make decisions

ethics

•beliefs, assumptions; help us to make decisions. Based on culture and experiences

ethics

ethics versus values

ethics = guidelines for conduct values = principles and ideals that help in judgement of what is important

•Inclusion of issues of culture •Culture and nursing/health care are related

ethnography

-Research •Randomized controlled trial (RCT) •Integrative review •Meta-analysis -Practice-based evidence for continuous process improvement (PBE-CPI)

evidence-based

purpose of communication

exchange info get to know patients and build a relationship with them good communication keeps morale up

•Conducted in laboratory setting •Looking at cause and effect relationships between variables under very controlled conditions

experimental

Importance of experienced nurses

expert mentors that need to be kept in the system

what might occur after an incident report?

extensive medical exam

Unauthorized prevention of movement

false imprisonment

(Rape, murder) prison time in state or federal facility for more than a year

felony

keep promises/provide for all pt needs

fidelity

FEN stands for

foreign educated nurses

When are values formed and what are they affect by?

formed during life, affected by surroundings

willful misrepresentation that can cause loss or harm

fraud

theory for universal application

general systems theory

more blocks to effective communication

going unwanted advice - makes you look like you think you're superior agreeing - shuts down patient opinion and further thoughts disagreeing - offensive

Number of retiring RNs _______ than the number of students to fill

greater

•Descriptions of the subjects reality •Theory is developed based on experiences of subjects

grounded theory

Benefits of foreign educated nurses

helped with low number of RNs continues to help US needs

•respects others -Privacy, respect cultures

human dignity

what researched expect to find

hypothesis

how to manage risks

identify, analyze, and treat

Contracts with patients are often _______

implied

meaningful use of HITECH

improve maintain privacy better outcomes more efficient

How is nursing school enrollment?

increasing but not in great enough numbers to replace the numbers of retirees

manipulated and effect dependent variable

independent

type of reasoning •builds from specific ideas or actions to conclusions about general ideas

inductive reasoning

which legal safeguard is needed for admission, routine treatment, diagnostics, surgeries, or procedures nurse is to confirm and answer questions

informed consent

devices used to collect/record

instruments

honesty and practices accountability

integrity

ability to share pt data across HC systems its, their families, and HCP can send, received find, and use GOAL - easy access, sharing of data no matter where pt is located

interoperability

3 levels of communication

intrapersonal, interpersonal, group

review of literature/purpose

introduction

How does standards of patient care change when there is understaffing, floating, mandatory overtime?

it doesn't! Patient safety and standards still held

give each his or her due and act fairly

justice

exploring opportunities on their own with no guidance; may struggle with conflicts

laissez-faire

-Nurse leaders, management objectives

leadership

Various councils

leadership clinical resource professional practice professional development quality

-Developed by legislature -Minimum standards for education, set requirements for licensure, decide when a nurse's license may be revoked/suspended

legal

educating a patient is a _____ _____

legal duty

coverage for nurse outside of the work environment; protect the nurse's best interest

liability insurance

•Candidate meets minimum requirements to practice

licensure

key skills to facilitate a helping relationship

listening silence touch humor

How else does aging nursing population and retirement affect the nursing profession?

loss of experience "older" nurses act as role models increase in age of faculty nursing schools

negligence by professionals

malpractice

Problems of hiring FEN

may hurt DOMESTIC job market drain on international health care systems

4 components of communication

message - info/product; comes from source Chanel - how the message is communicated source - who is charing the info receiver - one who interprets the message

how the study was done

methods

less serious crime, punishable with FINE, prison time less than a year

misdemeanor

•Includes the mixing of qualitative and quantitative methodologies •Takes advantage of using multiple ways to explore a research problem

mixed methods

A mother always thanks clerks at the grocery store. Her daughter, age 6 years, echoes her thank you. The child is demonstrating what mode of value transmission? Moralizing Modeling Responsible Choice Rewward and Punishment

modeling

doing things in a society that are acceptable or not acceptable; learning from family or peers

modeling

taught by parents or an institution (like the church) about what is right and wrong; not allowed to weigh the options

moralizing

standards for what we consider right and wrong

morals

act of omission or commission (what a "reasonably prudent person WOULD or WOULD NOT do")

negligence

unintentional tort

negligence and malpractice

•influenced where nursing began and evolved. (Nurs/MED, health vs illness)

nightingale

A nurse knows the ethical term "Do not cause harm" is an example of:

nonmaleficence

how is nursing practice regulated?

nurse practice acts standards credentialing

•nurses making ethical judgments -End of life; HIPAA; practices of colleagues

nursing ethics

Patient outcomes are sensitive to _______ _________/_________

nursing interventions/staffing

where do you not put in incident reports?

nursing notes

you can use the ______ _____ to make ethical decisions

nursing process •Assess the situation (gather data) •Diagnose (identify) the ethical problem •Plan •Implement your decision •Evaluate your decision

Code of ethics is an expression of...

nursing's own understanding of its commitment to society

improve processes, maximize use, reduce errors and costs, improve user satisfaction and minimize interruptions updating content (care plans) frequently ORDER of screens create ALERTS (medication alert, doage amount, # of doses) allow flow of Fata and pt info to all section use staff as VITAL voices for suggestions

optimization

phases of a helping relationship

orientation - set stages, roles, and contract working - teach and lead, unequal sharing of information termination - end of shift/discharge

Increasing amount of RNs moving to which care settings?

output/ambulatory

-act as a parent/prevent harm; overstepping advocacy

paternalism

goal of motivational interviewing

patient confidence

PICO

patient population intervention/issue of interest comparison (intervention/group) outcome sometimes T for time frame

a tool for patients to access their medical info

patient portals

Lack of long term ____ incentives More money available working as ____ ___

pay free agents

what is based on values?

perceptions and decision-making

•Describe experiences of those being studied •Meaning of the experiences

phenomenology

•values and beliefs; perceptions of life; in nursing, it is developed through what we learn and what we gain from practice experiences

philosophy

Who can write orders?

physicians NP PA healthcare provider

•civil law -Regulates relationships among people

private law

series of events that aim towards meeting a goal (NURSING PROCESS)

process

-Educational standards

professional development

-Standards; regulatory agencies

professional practice

•government is directly involved -Regulates relationships between individuals and government

public law

research method that is used to gain insight by discovering meanings; based on belief that reality is based on various and differing perceptions

qualitative

-Quality assurance; quality pt care

quality

research method that involves concepts of basic and applied research (mathematics)

quantitative

•Looks at cause and effect relationships between variables •Effects of nursing interventions on patient outcomes

quasi-experimental

always _______ order to confirm

question; repeat back to doctor while on phone; date, time, doctor name, and your name

how does the need for EBP arise?

questions arising in practice settings nurses empowered to ask critical questions decision making to affect outcomes best answers, decisions informed, EB analysis of each situation

literature used

references

repeat what the patient says

reflection

key aspects of motivational interviewing

reflective listening positivity open-ended questions let patient say how they think they can change

how has HC changed for effective and efficient interventions?

reimbursement insurance coverage

•Development of a personal value system is made and support and guidance is offered along the way children allowed to explore different values, their use and consequences

responsible choice

findings/charts/tables

results

What are some solutions to declining nursing numbers?

retain older staff health promotion, continuing eductions, less physical strain and mental exhaustion

A hospital is switching to computerized charting. The nurse recognizes that one advantage to an electronic client chart is: retrieval of information is more efficient no other charting method is necessary it is less costly to maintain access is open to anyone

retrieval of information is more efficient

prize when rules followed, consequence if not punished punishment for not following parent's values following HC recommendation you will probably heal faster

rewarding and punishing

which area has the greatest shortage, rural or urban?

rural (country)

•we use knowledge and observe, investigate and explain occurrences that take place

science

knowledge that arrived at through the scientific method (foley catheters drain completely when hung at the end of the bed..full extension of tubing)

scientific

nurses are responsible for safe management/use of passwords (QSEN competency and HIPAA) patient info is much easier to access now compared to paper charts

security and privacy

•teamwork, problem-solving, and accountability, with the goals of improved staff satisfaction, productivity, and patient outcomes. • working together to make decisions that affect nursing practice and patient care. •working together to make decisions that affect nursing practice and patient care. •working with other disciplines for the good of the patient •collaborating to improve nursing practice.

shared governance

slows down the convo, helps to watch, and allows the patient to collect their thoughts

silence

An informatics nurse is assisting with the design of an clinical information system for use by the staff of a health center. The nurse is working to ensure that the system reflects usability by making sure that the screen display is visually clean and uncluttered and that it provides only the information needed for decision making. Which concept of usability is the nurse incorporating? naturalness simplicity consistency forgiveness

simplicity

SOLER acronym

sit squarely open posture lean forward eye contact relax

A client on a surgical unit asks for the nurse's opinion of the surgeon. The nurse replies, "He is rude. His clients always end up with infections." The nurse is at risk of being accused of which of the following? Negligence Slander/Defamation Libel Assault

slander/defamation

•equal treatment for all -Uphold principles

social justice

•After WWI and II , more emphasis was on nursing EDUCATION, rather than just practical experience and research was published.

society

In comparison with licensure, which measures entry-level competence, what does certification validate?specialty knowledge and clinical judgment innocence of any disciplinary violation more thn 10 years of nursing practice ability to practice in more than one area

specialty knowledge and clinical judgment

use of this versus free text need for nursing to be a part of contribution to positive outcomes goals - providers have right data, at the right time, to make accurate and safe decisions

standard terminologies

enacted by a legislative body

statutory law

Nursing informatics specialists

superusers - works in a facility and becomes an expert on using the system AP degrees - masters program or certification program to get more knowledge and theory on nursing informatics

The _______ is who is working and who CAN work but is not working

supply

the extent to with a product (EHR/EMR) can be used to meet goals efficient and effective easy to use save time, reduce errors, improve user satisfaction

system usability

Knowledge

taking that information and relating it to other terms and other bits of knowledge RELATIONSHIP with data and info

•Patients staying in their homes •APPS, tracking tools, med reminder systems

telecare

Delivery of medical/diagnostic/tx services

telemedicine

Data

terms that are described but not used as an interpretation

•Standard or rule of conduct established and enforced by government -Designed to protect the rights of the public

the law

•group of concepts that describe a pattern of reality -Can be tested, changed, or used to guide research

theory

•ALSO a wrong committed by one against another or his or her property •May be intentional or UNINTENTIONAL acts of wrongdoing

tort

types of nonverbal communication

touch, eye contact, facial expressions, posture, gait, gestures, dress, silence, and body language

source of evidence: -Consultation with more experienced, educated, higher-authority-level nurse -Institutional standards, procedure manuals -Coworkers, other health care providers

tradition-based

knowledge passed down from generation to generation ( " we have always done it this way!")

traditional

culture where people do the right thing because it is the right thing to do.

transformative ethical leadership

Wisdom

using the best quality of knowledge to manage the data you have and solve the problem

•Whether an action is RIGHT or WRONG depends on the consequences of the action.

utilitarian

There is an increase in faculty _________

vacancies

ethics and morals help us to develop _____

value

two types of these; varies, has different values & can be measured

variables

invasion of privacy

violation of HIPAA

a behavior showing signs of high oral standards; what we do to be "good"

virtue

•Developed by nursing -NOT MANDATORY, but used as guidelines for review by peers •Examples: ANA, standards for the certification of nurses in general/specialty areas

voluntary

key qualities to facilitate a helping relationship

warmth openness empathy caring honest privacy respect

1. Shortage of nursing is happening _______ 2. Greatest in ______ care

worldwide acute

How can we promote unemployed nurses to work again?

• Part time opportunities should be available • Flexible and shorter shifts • Re entry of older nurses

Other causes of shortage based on changes in nurses

• Workplace dissatisfaction • Other fields more appealing to potential nurses • Aging RN faculty • Low ceiling on wages

Ethical consideration in nursing:

•Balance between benefits and harm in care of patients •Disclosure, informed consent ,shared decision making •Norms of family life •Relationship between clinicians and patients •Professional integrity of clinicians •Cost effectiveness and allocation •Issues of Cultural/Religious Variation •Consideration of Power

Examples of reliable research groups

•Cochrane Collaboration : international group of scholars who conduct reviews of research topics. • Agency for Healthcare Research and Quality (AHRQ): resources for research reviews and summaries -NGC: National Guideline Clearinghouse : (www.guideline.gov) resource for practice guidelines

types of quantitative research

•Descriptive •Correlational •Quasi-experimental •Experimental

what are goals of research?

•Develop explanations (in theories) •Find solutions to problems

benefits of nursing theory

•Directs nurses toward common goal •Leads to improved patient care •Provides rational and knowledgeable reasons for nursing actions •Gives nurses knowledge base necessary for appropriate actions •Helps resolve current nursing issues •Prepares nurses to question assumptions and values •Serves research, education, and practice

what are controlled substances?

•Drugs with potential for abuse -Narcotics, stimulants,depressants •Locked

Key aspects of documentation

•Factual, accurate,complete,entered in timely fashion •If it is not in the chart..IT WAS NOT DONE!

purpose of shared governance

•Gives nursing a voice •AIM: to ultimately increase employee and patient satisfaction while continuing to improve pt safety.

goal of nursing theory frameworks

•Holistic patient care •Individualized care to meet needs of patients •Promotion of health •Prevention or treatment of illness

how to implement evidence-based practice

•Identify area of concern ( ASSESS) •Review published material on subject •Critique and analyze the published material making sure it is accurate and relates to concern

what are goals of nursing research?

•Improve care of people in clinical setting •Study people and the nursing process -Education - retention rates -Policy development - committees in the facility -Ethics -Nursing history •Develop greater autonomy and strength as a profession •Provide evidence-based nursing practice

What is required of research conductors and participants?

•Informed consent •Federal regulations •Review boards

5 ways values are developed

•MODELING •MORALIZING •Laissez-faire •Rewarding and punishing Responsible Choice

What should you do to ensure patient got proper education about care?

•Must document teaching and response of pt and family •Agency policies will dictate level of responsibility

additional sources of evidence

•National standards of care •Pathophysiologic data •Quality improvement data •Patient and family preferences •Benchmarking data •Clinical expertise •Cost-effectiveness analyses •Infection control data •Medical record review data

What and when should you document

•Patient problems •Continuity til problem is resolved •INCIDENTS: facts only •Pt noncompliance

common concepts in nursing theory

•Person (patient) - always number one, explain problem, solving •Environment •Health •Nursing

qualitative research methods

•Phenomenology •Grounded theory •Ethnography •Historical

goals of EBP

•Provide optimal patient care •Improve patient (SYSTEM) outcomes control of HC costs patient satisfaction

Common malpractice "mistakes"

•Pt safety •Performance of treatment •Monitor and report •Med errors •Following agency policy •Documentation •Equipment

Best sources for EBP

•Research -MEDICINE/PHARM use RCT (Randomized Controlled Trials); compare intervention to placebo -NURSING: Qualitative, descriptive or quasi- experimental are common •DO PRACTICING NURSES HAVE TIME for this??????

EBP is shared decision making based on...

•Research evidence •Patient's experiences and preferences •Clinical expertise •Other sources of info

Safegaurds to competent practice

•Respecting legal boundaries of practice •Following institutional procedures and policies •Owning personal strengths and weaknesses •Evaluating proposed assignments •Keeping current •Respecting patient rights and developing rapport with patients •Keeping careful documentation •Working within agency for management policies

Aspects of risk management

•SAFETY: patients, employees, visitors •EQUIPMENT/PRODUCT safety: ongoing maintenance, evaluation, repair •QUALITY ASSURANCE: give best of care to patients. Ongoing evaluations of care

purpose of OSHA

•Safe working conditions -Use of electrical equipment -Use of isolation techniques -Use of radiation -Use of chemicals

how to ensure competent practice

•Safeguard •Educational and clinical background can help fulfill responsibilities outlined in job description. •Keeping current •Careful documentation Be sensitive to potential pt accidents

library research

•Sources •LIBRARIANS •Searches •EXPERT research Librarians

aspects of student liability

•Students are responsible for own acts •Must be prepared •Do not carry out procedures unless prepared

Might need to get an order immediately. first in _____. second by ______

•Try to get order in writing..voice order to written must be countersigned in 24 hrs

How should you clarify the values of a patients

•Understand values of individuals we take care of •Choices are made by precedent or thought process •Identify important things in life •Discuss RANKINGS with patients •Consider the consequences!

characteristics of PT bill of rights

•While receiving care in hospital •Particular to the facility/agency

purpose of incident reports

•document occurrence, harm or potential harm •Not for disciplinary action •Identify patterns that may cause harm, inservice to prevent reoccurence •Facts for possible litigation