Nursing 104 Final
Jean Watson
-philosophy and science of caring and humanistic nursing -there are 10 factors that are core to nursing -this holistic outlook addresses the impact and importance of altruism, sensitivity, trust, and interpersonal skills
characteristic of nursing profession
1. ability to control it's own work 2. self-regulation 3. service to society 4. ethical practice
How much has the amount of male nurses increased by?
13.7%
Cadet Nurse Corps
2 year program developed in world war 2 that was proven to be very successful
Faye Abdellah
21 Nursing problems, client-centered interventions
-nursing -person -health -environment
4 concepts of nursing
TJC (The Joint Commission)
A national agency that conducts surveys of inpatient and ambulatory facilities and certifies their compliance with established quality standards.
professional organizations; good working conditions
A nurse should be active in ________ ______ and advocate for ____ _____ _______
core of professional knowledge
A nurse should develop a __ __ __ ___
hospital acquired condition
A term used to indicate an unintended and typically adverse patient-acquired condition occurring as a result of being cared for in a hospital
many helpful links, including: -what is new in never events -editors picks for never events including those from the AHRQ, journal articles, books/reports, newspaper/magazine articles, tools/toolkits, and web resources
AHRQ offers _
all one team
Belief in the people who are working to serve the customer
1923
By ____, all states had instituted examinations for permissive licensure
License Revocation
DWI results in
2-3 years
Diploma programs are _____ long
Fruitfulness
Does the theory generate new directions for future research?
Mandatory continuing education
Educational requirements imposed by individual states for renewal of a license.
Pharmacoepia; 700
Egypt had a ________ with _______- drugs
77
Exam reviews are required if grade is below a _____
Barbara Nichols
First African-American president of the ANA
Nurse Training Act
First instance of federal funding for nursing collegiate programs
85-92.99
Grading scale of B?
25%
How much is the final exam worth?
-Abstinence -Mutual monogamy -reduce number of sexual partners -condom use -male circumcision -using only clean needles and syringes (for drug use)
How to prevent HIV
1901
In _____, the ICN passed a resolution that each nation and state needed to examine and license its nurses
1924; Yale University
In ______, ______________ offered the first Baccaulearate Degree Nursing program
physicians
In the 60's health care decisions were made mainly by ____
economic ; fee-for-service
In the 60's, _____ incentives and __________ payment encouraged overuse of healthcare services
Bioethics
Interdisciplinary field within health care that has evolved with modern medicine to address questions that arise as science and technology produce new ways of knowing
Metasynthesis
Interpretive translations produced from the integration or comparison of findings from qualitative studies
Hippocrates
Known as the father of medicine, ______ was the first person to attribute disease to natural causes
9-12 months long
LPN or LVN programs are usually _______ long
1-2 years
Master's degree is ____ long
clinical indicators
Measurable items that reflect the quality of care provided and demonstrate the degree to which desired clinical outcomes are accomplished
disasters, violence, and terrorism
New learning skills required for major natural disaster events, new program, new options, and new skills needed for first responders -violence in society, school, workplace. abuse against women and children
-theory or practice -nursing education -scholarship -statistics
Nightingale is well remembered for her significant contributions to professional nursing in the areas of
virtuous
Nurses must commit to a _____ value system
Standard 6. Patient Advocacy and Empowerment
Nurses shall recognize the effect of health care policies, delivery systems, and resources on their patient populations and shall empower and advocate for their patients as indicated. Nurses shall advocate for the inclusion for their patient's cultural beliefs and practices in all dimensions of health care
values, customs, and spiritual beliefs
Nurses should respect people's ___, ___, and ____
3%
Participation is worth ____
-take antibiotics as prescribed for the full duration -vaccinate children against preventable diseases -follow a healthy lifestyle and reduce the need for antibiotics -throw away old medications and never self medicate
Prevention combat AntiMicrobial Resistance (AMR) consists of:
Renal Disease Program
Provided funding for dialysis treatments and renal transplants for patients with kidney failure
never events
Serious but preventable errors that should never occur
-knowlege -skills -attitudes
The QSEN competencies assess the ____,_____, and _____ of nurses within six areas
DNP (doctor of Nursing Practice)
The ___ is conceived as preparation for contemporary advanced nurse practitioners
1982
The first NCLEX was developed in ___
-clinical consultant -staff developer -mentor -corporate supporter
The nurse serves as what four things in the healthcare team?
Licensure by endorsement
The original program whereby nurses licensed in one state seek licensure in another state without repeat examinations. The requirements are included in state nurse practice acts or accompanying rules and regulations.
-critical thinking -communication -assessment -leadership -technical skills
What are the 6 core competencies?
-communication with nurses -communication with doctors -responsiveness of hospital staff -pain management -communication about medicines -cleanliness and quietness of hospital environment -discharge information -overall rating of the hospital
What criteria make up the Hospital Consumer Assessment of Healthcare Providers and Systems
that all advanced practice education programs move from the master's to the doctoral level by 2015
What has the AACN recommended?
68.99 and below
What is the grading scale for an F
desirable nursing practice standards and nursing education
What should a nurse, according to ICN, be determining and implementing in her profession?
-nursing education -student characteristics -student satisfaction
What was the research focus in the 1900s-1940s?
-Teaching -Administration -Curriculum issues
What was the research focus in the 1950s-1970s?
-more qualified researchers -widespread availability of computers for data collection and analysis -qualitative studies
What was the research focus in the 1980s?
-Ventilation and Warming (clean warm air) -Noise (no sudden noise, music is good) -Variety (colors, flowers, pets) -Diet (easy foods to digest) -Light (taking the patient outside, keeping rooms well lit) -Chattering Hopes and Advices (Do not give false hope) -Cleanliness (prevent infection)
What were the concepts in Florence Nightingale's environmental adaptation theory?
2008
What year did Medicare stop paying hospitals the extra costs for treating preventable errors?
almshouses or pesthouses
Where were individuals with infectious disease isolated in?
Benjamin Franklin
Who advocated for hospital and care of the sick?
Helen Hurst
Who is the BSN Department Head?
Deedra Harrington
Who is the BSN coordinator?
Lisa Broussard
Who is the associate dean?
Melinda Oberleitner
Who is the dean?
International Council of Nurses and the American Nurses Association
Who made codes of ethics for nurses?
2-4 years
a bachelors degree in nursing is ____ long
abstract
a brief overview of a research study
comprehensive emergency management
a broad style of emergency management, encompassing prevention, preparedness, response, and recovery
constituent
a citizen who has the opportunity to vote for candidates in elections for representation at the local, state, and federal level
schematic model
a diagram or visual representatives of concepts, conceptual models, or theory
Mass casualty incident (MCI)
a disaster situation that results in a large number of victims who need the response of multiple organizations
Naloxone
a drug that can reverse the effects of opioid overdose and can be lifesaving
Nonmaleficence
a duty to not inflict harm, to abstain from injuring others and to help others further their own well-being by removing harm and eliminating threats
Patient Protection and Affordable Care Act
a federal statute enacted in 2010 that requires all citizens and legal residents to have health insurance
Pareto Chart
a graphic tool that helps break down a big problem into its parts and then identifies which parts are the most important
team
a group of people organized to accomplish the necessary work of an organization
Institutional Review Board (IRB)
a human subjects committee that examines research proposals to make sure that the ethical rights of those individuals participating in the research study are protected
CNL (clinical nurse leader)
a master's prepared generalist clinician who oversees the care coordination of a distinct group of patients, evaluates patient outcomes, and has the decision making authority to change care plans when necessary
Retrospective payment system
a method of reimbursing health care providers in which the professional services are rendered and charges are billed based on each individual service provided
Capitation
a method of reimbursing providers in which the insurance company pays the provider a set payment each month to provide a defined set of heath care services for the patient enrolled in the insurance company's health plan
incident command system (ICS)
a multiagency operational structure that uses a model adopted by the fire and rescue community
National Student Nurses Association (NSNA)
a national organization of statewide student nurse associations: concerned with education and career issues and provides student perspectives to other national nursing organizations
survey
a nonexperimental research design that focuses on obtaining information regarding the status quo of a situation, often through direct questioning of participants
Institute for Safe Medication Practices (ISMP)
a nonprofit healthcare agency whose primary mission is to understand the causes of medication errors and to provide time-critical error reduction strategies to the healthcare community, policymakers, and the public
all-hazards approach
a process approach for all sectors to prepare for any emergency or disaster that may occur
peer review
a process by which a scholarly work is checked by a group of experts in the same field to make sure it meets the necessary standards before it is published or accepted
values clarification
a process by which people atttempt to examine the values they hold and how those values function as a part of the whole
grounded theory
a qualitative research design used to collect and analyze data aiming to develop theories grounded in real-world observations
Ethnography
a qualitative research method for the purpose of investigating cultures that involve data collection, description, and analysis of data to develop a theory of cultural behavior
Mutual recognition model
a regulatory model developed by the National Council of State Boards of Nursing, which allows for multistate licensure
secondary analysis
a research design in which data previously collected in another study are analyzed for different aims than the original study
the nuremberg code
a set of provisions for research that must be followed for the federal government to approve research
Disaster condition
a significant natural disaster or man-made event that overwhelms the affected state, necessitating both federal public health and medical care assistance
marginalized population
a subgroup of the population that tends to be hidden, overlooked, or on the outer edge
CCNE (Commission on Collegiate Nursing Education)
a subsidiary of the AACN with responsibility for accrediting baccalaureate and higher degree nursing programs
crisis standard of care
a substantial change in susual health care operations and the level of care it is possible to deliver, which is made necessary by pervasive or catastrophic disaster
Methadone
a synthetic opioid
Failure Mode and Effects Analysis (FMEA)
a systematic process for identifying potential design and process failures before they occur, with the intent to eliminate them or minimize the risk associated with them
compact state
a term of law, a state that has established an agreement with other states allowing nurses to practice within the state without an additional license
quasi-experimental research
a type of quantitative research study design that lacks one of the components of an experimental design
continued competency program
a variety of initiatives to ensure nurses' knowledge , skills, and expertise beyond initial licensure
Influenza
a virus that affects the respiratory system, contagious by droplets, typically a seasonal illness
social justice
acting as a health care advocate, allocating resources fairly, reporting incompetent, unethical, and illegal practices objectively and factually
integrity
acting in accordance with an appropriate code of ethics
integrity
acting in accordance with an appropriate code of ethics -moral, ethical, and legal professional behavior -honest and provides care based ob an ethical frame, work that is accepted in the profession
Social Justice
acting in accordance with fair treatment regardless of economic status, race, ethnicity, age, citizenship, disability, or sexual orientation
Social Justice
acting in accordance with far treatment regardless of economic status, race, ethnicity, age, citizenship, disability, or sexual orientation -courage, integrity, morality, objectivity -acts as a health care advocate
technical operations
actions to identify, assess, dismantle, transfer, dispose of, or decontaminate personnel and property exposed to explosive ordnance or weapons of mass destruction
recovery
activities designed to return responders and the facility to full normal operational status and to restore fully the capability to respond to future emergencies and disasters
Preparedness
activities that build capability and capacity to address the potential needs identified by the threat and vulnerability study
response
activities to address the immediate and short-term effects of an emergency or disaster
preventive care, home care
acute care became
Paternalism
an action and an attitude wherein the provider tries to act on behalf of the patient and believes that his or her actions are justified because of a commitment to act in the best interest of the patient
Clinical nurse researcher (CNR)
an advanced practice nurse who is doctorally prepared and directs and participates in clinical research
Clinical nurse specialist (CNS)
an advanced practice nurse who provides direct care to clients and participates in health education and research
Utilitarianism
an approach that is rooted in the assumption that an action or practice is right if it leads to the greatest possible balance of good consequences or to the least possible balance of bad consequences. The best decision is one that brings about the greatest good for the most people
Deontology
an approach that is rooted in the assumption that humans are rational and act out of principles that are consistent and objective and compel them to do what is right. says that a decision is right only if it conforms to an overriding moral duty and wrong only if it violates that moral duty. Persons are to be treated as ends in themselves and never as means to the ends of others
minority
an ethnic group that is smaller than the majority group
clinical practice guidelines (CPG)
an evidence bsed guide to clinical practice developed by experts in a particular field for direct application in clinical environments
ANCC (American Nurses Credentialing Center)
an independent agency of the american nurses association that conducts certification examinations and certifies advanced practice nurses
Active Shooter
an individual actively engaged in killing or attempting to kill people in a confined an d populated area; in most cases, active shooters use firearms and there is no method to their selection of victims
emergency management assistance compact (EMAC)
an organization authorized by the US congress through which a state impacted by a disaster can request and receive assistance from other member states quickly and efficiently
sentinel event
an unexpected occurrence involving death or serious physical or psychological injury, or the risk thereof
State-of-the-science summary
an up-to-date merging of findings from several studies concerning the same topic
weapon of mass destruction (WMD)
any explosive, incendiary, or poison gas, bomb, grenade, rocket having a propellant charge of more than 4 ounces
Standardization
approach to process improvement that involved seveloping and adhering to best known methods and repeating key tasks in th esame way, time and time again, until a better way is found, thereby creating exceptional service with maximal efficacy
sophistication; cost
as ________ of technology rises, the ______ of medical technology also rises
terrorist incident
as defined by the FBI, a violent act or an act that is dangerous to human life, in violation of the criminal laws of the UNited States or of any state and intended to intimidate or coerce a government, the civilian population, or any segment thereof in furtherance of political or social objectives
lead agency
as defined by the FBI, the federal department or organization assigned primary responsibility to manage and coordinate a specific function- either crisis management or consequence managament
major disaster
as defined in the Stafford Act, any natural catastrophe, or, regardless of cause, any fire, flood, explosion in any part of the US that in determination of the President causes damage of sufficient severity and magnitude to warrant major disaster assistance under the Stafford Act to supplement the efforts and available resources of states, local governments, and disaster relief organizations in alleviating the damage, loss, hardship, or suffering caused thereby
emergency
as defined in the stafford act, any occasion or instance for which, in the determination of the president, federal assistance is neeed to supplement state and local efforts and capabilities to save lives and protect property, public health, and safety ; includes emergencies other than natural disasters
Stereotyping
assigning certain beliefs and behaviors to groups without recognizing individuality
speech-language pathologist
assists clients who are communicatively impaired by intervening in speech, language, or swallowing disorders related to receptive language, expressive language, speech intelligibility, voice disorders, alaryngeal speech
physical therapist
attends to the client's needs for movement, assessing physical strength, mobiiity needs, range of motion, develops a plan of strengthening exercises, identifying assistive devices needed
chaplain or pastoral
attends to the spiritual and emotional needs of the client and family
Margaret Newman
central components of this model are health and consciousness followed by concepts of movement, time, and space -all components are summative units, described in relationship to health and to each other
Diagnostic Related Groups (DRGs)
changed Medicare reimbursement to hospitals from a fee-for-service method to a fixed-fee method
TRICARE: military health insurance
civilian health care insurance program for military, spouses, dependents and beneficiaries.
interprofessional teams
collaborative practice relationships among several disciplines of health care professionals
Data Capture
collection and entry of data into an EHR
patient support
computer-based patient education and home monitoring where applicable
order entry and order management
computerized provider order entry with or without decision support to eliminate lost orders and illegible handwriting, generate related orders automatically, monitor for duplicate or contradictory orders, and reduce time to fill orders
altruism
concern for the welfare of others -caring, commitment, compassion, generosity, perseverance -giving full attention to the client when giving care
-overuse of expensive invasive technology -underuse of inexpensive care services -error-prone implementation of care that could harm patients and waste money
contributing factors to poor quality of care
nurse
coordinator of the team, take licensure examinations after completing associate or baccalaureate degree preparation fro an accredited school of nursing; able to obtain specialty certification for advanced skills and advanced degrees
-objectivity -accuracy -usability -currency
criteria for good information technology
Accreditation
cultural competence is mandatory for _____
empirical
data gathered through the senses
scientific approach
decisions about quality improvement are made with organizational support for all employees to develop knowledge and skills in the science of QI
Virginia Henderson
definition of nursing -nursing assists patients through 14 functions toward independence
RWJF New careers in nursing scholarship program
designed to alleviate the nation's nursing shortage by dramatically expanding the pipeline of students from minority backgrounds in accelerated nursing programs
Accuracy
does the theory explain restrospective concurrences? Does the theory maintain its capacity to predict future outcomes?
Dorothea Dix
during the civil war, she established a reputation as an advocate for female nurses, administered military hospitals
Nurse Practice Act
each state develops a ____ with rules and regulations to govern the practice of nursing within that state
increase in chronic illnesses, social isolation and depression resulting from loss of family and friends
effects of people living longer
Doctoral Advancement in Nursing (DAN) project
enhances the number of minority nurses achieving DNP or PhD degrees
-chemical impairment -negligence -abusiveness -incompetence -cruelty
examples of wrongdoings in the workplace that require whistle-blowing?
obesity
excessive accumulation of adipose tissue and body mass index over 30 kg/m2
increased risk of health problems such as: -injuries -violence -liver diseases -cancer
excessive alcohol use, including underage drinking and binge drinking can lead to ___
cerebral vs biological death, euthanasia or assisted suicide, end-of-life decisions
give some examples of bioethical dilemmas regarding death
altruism
giving full attention to the client when giving care, assisting other personnel in providing care when they are unable to do so, expresses concern about social trends and issues that have implications for health care
93-100
grading scale of A?
Naturalistic paradigm
holistic view of nature and the direction of science that guides qualitative research
autonomy
honoring an individual's right to refuse treatment , providing nursing care based on respect of patient's rights to make decisions about their health care
noninstitution based (clinic or home)
hospital or institution based became
-key entry -pattern recognition medical device transmission
how can data be captured?
20%
how much are exams worth?
1/2 of hospital revenues and 1/4 of physician incomes
how much influence does the government have related to hospital revenues and physician incomes?
2%
how much is a quiz worth individually?
Baccalaureate Outcomes and Competencies
identifies core competencies, ways to learn them, indicators that define them, ways to document that learners achieve them
Technology advancements
influenced all populations including developing countries that have limited access to health care
.net
internet service provider
information communication
interoperability of systems and linkages for exchange of data across disparate systems
nursing, medicine, pharmacy, nutrition, social work, case management, physical therapy, occupational therapym respiratory therapy, speech therapy
interprofessional teamwork includes ____
.08
legal limit of alcohol level
advanced practice nurse
legal title for nurses prepared by education and competence to perform independent practice
african american
life expectancy is shorter for what population group?
obesity, smoking, alcohol, illicit drugs
lifestyle choices that are related to health issues
Quality and Safety Education in Nursing (QSEN)
made a project that was created to support development of six competencies for nursing students and nurses
tobacco products
made entirely if partly of leaf tobacco as raw material, which are intended to be smoked, sucked, chewed or snuffed
-Nazi Experiments -Tuskegee syphilis study -Jewish Chronic Disease Hospital In NY
name three historical examples of unethical research?
opioid
natural or synthetic chemicals that interact with endorphin receptors on nerve cells in the body and brain, and reduce the intensity of pain signals and feelings of pain
IOM
nonprofit organization with a mission of advancing and disseminating scientific knowledge to improve human health
Standard 7: Multicultural workforce
nurses shall actively engage in the effeort to ensure a multicultural workforce in the health care setting. one measure to achieve a multicultural workforce is through strengthening of recruitment and retention effort in the hospital and academic setting
Standard 12: Evidence-based practice and research
nurses shall base their practice on interventions that have been systematically tested and shown to be the most effective for the culturally diverse populations that they serve. in areas where there is a lack of evidence of efficacy, nurse researchers shall investigate and test interventions that may be the most effective in reducing the disparities in health outcomes
Standard 8: Education and training in culturally competent care
nurses shall be educationally prepared to promote and provide culturally congruent health care. Knowledge and skills necessary for assuring that nursing care is culturally congruent shall be included in global health care agendas that mandate formal education and clinical training, as well as required ongoing
safe
preventing injuries to patients from the care that is intended to help them
LDH
protects and promotes health and esnures access to medical, preventive an rehabilitative services for all citizens of Louisiana
Institute of Medicine
recognized the essential qualities of nursing in the success of reforming the US health care system
Hospital Readmissions Reduction Program
reduces Medicare payments to hospitals with excessive readmissions
timely
reducing waits and sometimes harmful delays for both those who receive and those who give care
Confidentiality
refers to the act of limiting disclosure of private matters
privacy
refers to the right of an individual to keep information about him or herself from being disclosed to anyone else
mental health parity and addictions equity act
removed discrimination in insurance coverage and benefits for mental illnesses and substance abuse disorders
human dignity
respect for the inherent worth and uniqueness of individuals and populations
administrative processes
scheduling systems, billing and claims management, insurance eligibility, and inventory management
Martha E. Rogers
science of unitary human beings -energy fields, openness, pattern, and organization -nurse promotes synchronicity between human beings and their universe and environment
Ethics
science or study of moral values
Dorothea Orem
self-care model -nursing facilitates client self care by measuring the client's deficit relative to self care needs
Colonel Julia O Flikke
served in both world wars as a nurse
credible threat
situation in which the FBI determines that a terrorist threat is credible and confirms the involvement of a weapon of mass destruction in the developing terrorist incident
-isolation -quarantine -restrictions
social distancing needed for pandemic influenza
decision support tools
software programs that process data to produce or recommend decisions by linking with an electronic knowledge base controlled by established rules for combining data elements; the knowledge base and rules mimic the knowledge and reasoning an expert health professional would apply to data and information to solve a problem
customer
the _____ defines quality
Synergy
the ability of a group of people working together to accomplish significantly more than each person working individually
Scene Assessment
the act of reviewing the locati9on of an event to look for information that might help to determine treatment options
preexisting illness
the affordable care act allowed for people with _____ _____ to have insurance
Randomization
the assignment of subjects to treatment conditions in a random manner
autonomy
the challenge of advance directives, consent or refusal of treatment; competency issues; minors, emergency situations, confused older adults, mentally compromised, inebriated, imprisoned, unconscious
security
the means to control access and protect info from accidental and intentional disclosure to unauthorized persons and from alteration, destruction, or loss
earnings are tied to procedures
the more tests and procedures performed, the greater the physician's earnings. why?
team builder
the nurse is the ____ ____
respect; cooperation; commitment; willingness to accomplish shared goals
the nurse, as a team builder, must sere as a role model to encouragae and help develop team principles of ____, _____, ___, and _____
whistle-blowing
the obligation to denounce a harmful action or potentially threatening situation committed by a colleague
3rd
the opioid epidemic has caused opioid use to be the ____ leading cause of death
20th century
the outbreak of HIV began in the __
Contemporary Issues
the problems, changes, and concerns that are current for the present time
STEEEP
the quality chasm report by the IOM poses 6 guiding aims called ___
12%
the quiz category is ____ of grade
Competency outcomes
the results or end products of planned study and experience that are focused on specific abilities required for practice
platform
the statement of principles and policies of a political party, candidate, or elected official
Triangulation
the use of a variety of methods to collect data on the same concept
Health Information Technology
the use of various forms of technology to improve the quality of health services to individuals and communities
Madeline Leininger
theory of cultural care diversity and universality -transcultural an caring nursing -concepts are aimed toward caring and the components of a culture care theory -diversity, universality, worldview, and ethnohistory are essential to the four concepts of care, caring, health, and nursing
Rosemarie Rizzo Parse
theory of human becoming proposes that quality of life from each person's individual perspective should be the goal of nursing practice
Ida Jean Orlando
theory of the nursing process -deliberate nursing approach that stresses the action of the individual client in determining the action of the nurse -focus is on the present or short-term outcome
Health Information Technology
there is a widespread use of ___ ____ ______ in all countries
Confidentiality
there should always be ___ of people's personal information
autonomy
this concept holds that humans have incalculable worth or moral dignity not possessed by oter objects or creatures, there is uncondiotional intrinsic value for everyone, people are self-determining agents entitled to determine their own destiny
Mitigation
those activities designed to alleviate the effects of a major disaster or emergency or long-term activities to minimize the potentially adverse effects of future disasters in affected areas
-defined goals and objectives -a commitment to work together -good communication -willingness to cooperate
to create synergy, teams must have __
beneficient
to promote goodness, kindness and charity, provide benefits to others for their own good
Nicotine
tobacco contains __
pesticides and fertilizers
tobacco contains a huge amount of ___ and ____
cause and effect diagram
tool that is used for identifying and organizing possible causes of a problems in a structured format, sometimes called a fishbone diagram
cardiovascular disease, cancer, diabetes, chronic lung diseases
top cause of death, examples of noncommunicable diseases
synthetic opioid analgesics
tremadol and fentanyl
false
true or false? the inpatient facility EHR does not need to integrate with nursing services, pharmacy, operating room management systems, and laboratory informations systems.
True
true or false? the origin of the data captured may be local or remote from patient-monitoring devices, directly from the individual recipient of care, and even from others who have info about the patient's health or environment, such as relatives, friends, and public health agencies
monitoring for early recognition of adverse events, complications, and errors and initiating deployement of appropriate care providers for timely intervention and reponse/rescue of patients in these situations
two nursing functions that influence patient safety ad quality
clinical decision support and computerized provider order entry
two specific functions of the electronic health record as stated by the iom
-opiates -cannabis -cocaine -amphetamine
types of illicit drugs
Louisa May Alcott
union nurse during civil war
cost shifting
unpaid costs covered by those who do pay- increases insurance premiums
altruism
unselfish concern for the welfare of others
military nurse
upon successful completion of the NCLEX, the nurse can practice in other jurisdictions without additional licensure requirements
social worker
uses skills to help clients, families, and staff about community resources; discharge planning, financial counseling, and identifying financial resources
link searching
using the .gov advanced search: first result is the Centers for Medicare & Medicaid Services (CMS); second result is the Agency for Healthcare Research and Quality (AHRQ)
collective violence
violence against a group
-health care delivery -issues such as cost, quality, and access
what was the research focus in the 1990s
-high deductible health plan (HDHPs) -health reimbursement accounts (HRAs) -health saving accounts (HSAs)
what were the responses to increases in family plan premiums?
Sunset Legislation
when changes to a law or bill have a set approval date, and if they are not approved by that date, they will be changed automatically. Many rules and regulations in the Nurse Practice Act are written with this type of legislation
1980s
when did AIDS spread?
1970s
when did health care costs rise?
autumn and winter months
when does the flu usually infect the most?
true
when nurse witnesses a coworker harmfully affecting a patient or making a threatening situation in the workplace, if that nurse remains silent, she is consenting to the action of the threatening situation. true or false
professional members bring in-depth and specialized knowledge and skills to the interaction process
why are interprofessional teams valuable?
tripled; 1975
worldwide obesity has ____ since _____
Ethnicity
affiliation resulting from a shared linguistic, racial, or cultural background
third
alcohol is the _____ largest risk factor for disease burden
decision support tools
alerts and alarms for drug interactions, allergies, and abnormal laboratory results
health insurance exchange
also known as the "Health Insurance Marketplace" : an online market-place for individuals to shop fo rand purchase health insurance
Integrate best current evidence with clinical expertise and patient/family preferences and values, knowledge of basic scientific methods and processes, participate in data collection and other research activities, consult with clinical experts
evidence based practice QSEN core competency
US department of veterans affairs, CMS: centers for medicare and medicaid services
examples of federal health policy
free vaccinations, no smoking school campus, seatbelt law
examples of local health policy
LGBT community, recent immigrants from Russia, Rwanda, and Afganistan
examples of marginalized populations
substance abuse laws, nurse practice act
examples of state health policy
cultural sensitivity
experienced when neutral language, both verbal and nonverbal, is used in a way that reflects sensitivity and appreciation for the diversity of another
AHRQ and the NINR
federal funding of nursing research is done by __
-asian american -black -hispanic -pacific islander -american indian
federally defined minority groups
Susie Taylor
first black army nurse
Diane Ustal
first nurse leader to describe the role of values clarification
-improve quality, safety, and efficiency, and reduce health disparites -engage patients and their families in their health care -improve care coordination -improve population and public health -ensure adequate privacy and security protections for personal health information
five priorities of the EHR
Quantitative Research
formal, objective, systematic process used to describe and test relationships and examine cause-and-effect interactions among variables
moral development
forming a worldview and value system through an evolving, continuous, dynamic process that moves along a continuum of development
Lillian Wald
founded Henry Street Settlement House
Quality Improvement (QI)
framework for taking action to systematically make changes that lead to measurable improvements in health care services for patients, staff and organizations; quality is determined by the needs, expectations, and desired health outcomes of individuals and populations
penicillin and insulin; nurse anesthetics
from WWI-1920's, ________and _______ were developed and ____ ____ were certified
Sheppard-Towner Act
funded prenatal and child health centers staffed by public health nurses
Imogene King
goal attainment theory -goal attainment using nurse transactions -addresses the client systems and includes society, group, and the individual
77-84.99
grading scale of C?
69-76.99
grading scale of D?
run chart
graph of data in time order that help identify any changes that occur over time (time plot)
intimate partner violence
greatest cause of injury in women 15-24 years of age
Harriet Tubman
guided slaves to Underground Railroad, served during the war as a nurse, scout, and spy for the Union
Rome
had the first military hospital
Centers for Disease Control and Prevention (CDC)
has the logo "24/7 Saving lives. Protecting people" and serves to protect america from health, saftey, and security threats
Standard 5: Cultural competence in in health care systems and organizations
health care organizations should provide the structure and resources necessary to evaluate and meet the cultural and language needs of their diverse clients
by describing, explaining, and predicting everyday experiences
how do nursing theories help nurses
-improves communication -more readily accessible knowledge -requirement for key pieces of information -assistance with calculations -accuracy checks performed in real time -assistance with medication monitoring -decision support -rapid response to, and tracking of adverse events
how does the CPOE contribute to medical error prevention?
lost workforce productivity, strain health services
how does the influenza virus take an economic toll?
-through unprotected sex -transfusion of contaminated blood -sharing of contaminated needles -between a mother and her infant during pregnancy, childbirth, and breastfeeding
how is HIV spread
outcomes measurement and cost effectiveness
if it might help, use it became
unlawful or illegal
illicit drugs mean that the drugs are ____
preventive emphasis
illness emphasis became
chronic illness
illnesses that once led to mortality are now manageable and are classified as ___ ____
codes of ethics
implicit standards and values for the profession
cultural humility
incorporates a lifelong commitment to self-evaluation and self-critique, to redressing the power imbalances in the patient-clinician dynamic and to developing mutually beneficial and advocacy partnerships with communities on behalf of individuals and defined populations
Sociodemigraphics, cultural, diversity, economic, and political changes
increased aging population, increasing multicultural, ethnic diversity requires increased learning, respect for differences, preferences, customs, generational issues -immigration conflicts, protests, consequences for access and health care -community, faith-based projects, service -social, economic, and political changes influence health care delivery and access to clinical experiences
use info and technology to communicate, manage knowlegdge, mitigate error, support decision making, navigate the electronic health record, respond to clinical decision making supports and alerts
informatics
health information and data
information to make sound clinical decisions, such as past medical history, laboratory tests, allergies, current medications, and consent forms
community focused interdisciplinary approaches
interprofessional collaborative learning, diverse alternative health practices, influences of cultures -broad scope of nursing, clinical approach, increasing the use of diverse experiences throughout community, continuum from acute care to health promotion, from hospitals to home to rural to global settings
India
introduced surgery, prenatal care, and had hospitals filled with male nurses
Florence Nightingale
investigates the effect of the environment on healing
Integrative Research Review (IRR)
methodology ythat simultaneously synthesizes several experimental and non-experimental research findings to provide a comprehensive understanding of the phenomena of interest
biological agents
microorganisms or toxins from living organisms with infectious or noninfectious properties that produce lethal or serious effects in plants and animals
.mil
military site
19%
minority groups make up _____% of the RN population
Natural Opioid Analgesics
morphine and codeine
Acquired Immuno Deficiency Syndrome (AIDS)
most advanced stage of HIV infection
explosive
most common method for terrorists
performance based competency: learning and objective assessment methods
multiple teaching-learning methods: interactive collaborative, in-class, out of class projects, problem-based learning, increasing self-responsibility, accountability for learning and competence; interprofessional learning, using electronic devices, media to access resources -competence assessment based on performance examinations, specified portfolio documentation, etc
the wealth of information available through EHR
must be managed to ensure that authorized caregivers and others with legitimate uses have the information they need in their preferred presentation form
-infection control -quality management -specific client services -coordinator positions
name four hospital opportunities
quality of life, right to decide, informed consent, stem cell research, cloning, in vitro fertilization
name some exmaples of dillemmas in bioethics
-CNS -CNR -CNL -DNP
name the 4 nursing research roles
Standard 10 - Cross-Cultural Leadership
nurses shall have the ability to influence individuals, groups and systems to achieve outcomes of culturally competent care for diverse populations
Standard 11: Policy development
nurses shall have the knowledge an skills to work with the public and private organizations, professional associations, and communities to establish policies and standards for comprehensive implementation and evaluation of culturally competent care
Standard 4: Culturally competent practice
nurses shall use cross-cultural knowledge and culturally sensitive skills in implementing culturally congruent nursing care
permissive licensure
nurses were not required to be licensed, but it was encouraged for nurses to attain __________
didactic courses and clinical component
nursing curriculum consists of ___ and ____
energy imbalance
obesity causes an _____ _______ between calories consumed and calories expended
National Organization for Nurse Practitioner Faculties (NONPF)
organization for nurse practitioners in multiple specialties: sets national standards and criteria for programs and certification
Advance Care Excellence for Seniors (ACES)
organization that aims to advance the care of older adults through innovations in nursing education
NCSBN (National Council of State Boards of Nursing)
organization whose membership consists of the board of nursing of each state or territory
Healthy People
outlines goals for a broad-based population health set by government agencies
semi-synthetic opioid analgesics
oxycodone, hyrdrocodone, hydromorphone, and oxymorphone
point-of-care technology
paramount to deliver safe, efficient, high-quality patient care while accessing patient data and evident-based guidelines
philosophy
patient centered care is a _____ of care, not a delivery model
insulated; insurance
patients n the 60s were ____ from costs because ____ was paying the bill
Retrospective payment system
payment method and economic incentives contributed to increased costs
-children under than 5 -adults over than 65 -pregnant women -american indians and alaskan natives -people who have medical conditions
people at high risk of getting influenza
-ill and elderly -those in hospitals or long term care facilities -persons with AIDS or immunodeficiency disorders -persons with multiple chronic disorders such as diabetes or chronic kidney disease -those with previous exposure to MDRO
people with increased risk of developing MDRO
value
personal belief about worth that acts as a guide behavior
conduct of a smaller version of a proposed study that develops or refines methodology prior to use in a larger study
pilot study
Clara Barton
pioneering nurse who founded american red cross
occupational therapist
plans activities that assis and teach clients with physical disabilites to become independent in activities of daily living, such as dressing, grooming bathing, and eating
prejudice
preconceived, deeply held, usually negative, judgement formed about other groups
efficient
preventing waste, including waste of equipment, supplies, ideas, and energy
maximum functional status; health; independence
primary care providers are faced with promoting ___ _____ ______ and identifying risks to ___ and _____
Managed Care Organizations (MCOs)
private insurance companies began _________
Third-party payer
private or government organization that insures or pays for health care on behalf of beneficiaries
Accreditation
process by which an educational program is evaluated and then recognized as having met certain predetermined standards of education
Certification
process by which nurses are recognized for advanced education and competence
Triage
processed prioritizing which patients are to be treated first; first action in any disaster response
ANA
professional organization that represents all registered nurses
ICN (International Council of Nurses)
professional organization that represents nurses in countries around the world
grant
proposal developed to seek research funding from private or public agencies
Institutional Ethics Committees
provide ethics education, aid in policy development, serve as consultants to provide guidance in ethical dilemmas
Hill-Burton Act
provided federal funds to construct hospitals
balanced budget amendment
provided for direct reimbursement of NPs
The Essentials of Baccalaureate Education for Professional Nursing Practice
provides educational framework for preparation of professional nurses
Nursing Workforce DIversity Grants
provides funding for projects to increase nursing education opportunities for individuals from disadvantaged backgrounds, including racial and ethnic minorities underrepresented among registered nurses
managed care plans
provides oversight for the use of medical services
Minority Nurse Faculty Scholars Program
provides scholarship funding, mentorship and leadership development components that ensure successful completion of graduate studies and preparation for the faculty role
equitable
providing care that does not vary in quality because of personal characteristics such as gender, ethnicity, geographic location, and socioeconomic status
patient-centered
providing care that is respectful of and responsive to individual patient preferences, needs, and values and ensuring that patient values guide all clinical decisions
effective
providing services based on scientific knowledge to all who could benefit, and refraining from providing services to those not likely to benefit
Mary Seacole
purchased her own supplies and traveled 3000 miles to Crimea; built and opened a lodging house to nurse soldiers
Phenomenology
qualitative research design employing inductive descriptive methodology to describe the lived experiences of study participants
use data to monitor the outcomes of care processes, use improvement methods to design and test changes, continually improve the quality and safety in health care and describe approaches for changing processes of care
quality improvement QSEN competency
HIPAA
requires that all organizations and facilities that gather or collect personal health information are required to name an individual as privacy officer and develop policies and procedures to ensure the privacy and security of PHI (public health information)
Methodologic design
research design used to develop the validity and reliability of instruments that measure research concepts and variables
practice guidelines
research-based recommendations stated as standards of a practice, procedures, or decision algorithms
human dignity
respect for inherent worth and uniqueness of individuals and populations -consideration, empathy, humaneness, kindness, respectfulness -values and respects all patients and colleagues
Respiratory Therapist (RT)
responsible for assessment and maintenance of the client's airway and respiratory equipment used for diagnosis and therapy of respiratory disorders, aerosolized medication, sputum sampling, arterial and mixed venous sampling
pharmacist
responsible for providing drug therapy for positive client outcomes; activities include drug information services, client and health care staff education, dispensing medication and client monitoring
fee-for-service
retrospective payment system, member pays a premium for a fixed percentage of expenses covered
human immunodeficiency virus (HIV)
retrovirus that infects cells of the immune system. destroying or impairing their function
autonomy
right to self-determination
autonomy
right to self-determination -respectfulness, trust, objectivity -provides nursing care based on respect of patients rights to more decisions about their care
Minimizes risk of harm to patients and providers through both system effectiveness and individual performance, effective use of technology and standardization practices, exame human factors and basic safety design, values standardization practices that support safety
safety QSEN competency
information literacy
set of skills needed to find, retrieve, analyze, and use information
Culture
shared beliefs, values, and practices of a particular group of people hat are transmitted from one generation to the next and are identified as patterns that guide thinking and action
education trends
shifts in conditions and concerns that emerge from and influence various aspects of society, broad changes in the united states and the world that influence the education and practice of nurses and other providers
increasing shortage of nurses and faculty
shortage of staff results in limitations in clinical learning; heavy workload, using preceptors, part-time instructors, less one-to-one help for students, consequences for learning and patient safety
Morbidity
sickness and illness
chemical agents
solids, liquids, or gases with chemical properties that produce lethal or serious effects in plants and animals
which treatment is best for the patient? which of the new drugs should be used? should every patient be subjected to every possible form of diagnostic treatment? should patient be made aware of questions and various options surrounding care? is disclosure of uncertainty beneficial or detrimental?
some questions that challenge veracity, paternalism
Performance examinations
standardized evaluation based on objective demonstration of specific required competencies, used in conjunction with written tests of knowledge about those abilities
meta-analysis
statistical method of quantitative synthesis of findings from several studies to determine what is known about a phenomenon
Grandfathered
statutory process by which previously licensed persons are included without further action in revisions or additions in nurse practice acts
needs assessment
study in which the researcher estimates the resource needs of a group
control group
subjects in an experiment who do not receive the experimental treatment and whose performance provides a baseline against which the effects of the treatment can be measured
nursing ethics
system of principles that govern the actions of the nurse in relation to patients, families, other health care providers, policymakers, and society
Qualitative Research
systematic, subjective approach used to describe life experiences and give them meaning
Betty Neuman
systems model: wellness-illness continuum -promotes the nurse as the agent in assisting the client in adapting to and, therefore, reducing stressors -supports the notion of prevention through appropriate intervention
synergy
team building should create _____
foster open communication, mutual respect, shaed decision making, awareness of strengths and limititations as a team member, minimize risks associated with hand-off among providers
teamwork and collaboration QSEN competency
veracity
telling the truth; trust factor
National Database of Nursing Quality Indicators (NDNQI)
the ANA developed the _____ that is a voluntary database, collects national data, is a link between nurse staffing and patient outcomes, and a measurement program that allows comparison measures of nursing quality among nations, regional, state hospitals of similar tyoe and size
no links
the CMS offers ___
Accountability
the challenge that nurses have an obligation to uphold the highest standards of practice, to assume full and professional responsibility for every action, and to commit to maintaining quality in the skills and knowledge base of the profession
Rights Consciousness
the civil right that protects conscientious health care providers against discrimination, allowing them the right to act according to the dictates of their conscience
nursing science
the collection and organization of data related to nursing and its associated components
nursing theory
the compilation of data that defines, describes, and logically relates information that will explain past nursing phenomena and predict future trends
Assimilation
the cultural absorption of a minority group into the main cultural body
ethics acculturation
the didactic and experiential process of developing ethical reasoning abilities as a part of ongoing professional preparation
Deontology
the end does not justify the means
Utilitarianism
the ends justifies the means
core competencies
the essential cluster of abilities and skills required for competent nursing practice
1751; Pennsylvania Hospital
the first US hospital was established in ___ and was called _______ _________
Immaculate Conception; Mexico City
the first hospital in North America was the hospital of ______________ ________- in __________ _________
cardiovascular diseases, cancers, diabetes, and chronic lung diseases
the four main non-communicable diseases
information and technology
the hardware and software that enable information to be stored, retrieved, communicated, and managed
Stakeholders
the individuals, groups, and organizations that can affect the firm's vision and mission, are affected by the strategic outcomes achieved, and have enforceable claims on the firm's performance
generalizability
the inference that findings can be generalized from the sample to the entire population
nursing
the largest occupation in health care
Medicare
the largest public insurance entity
homicide
the leading cause of death in black males ages 15-34
electric health record (EHR)
the longitudinal electronic record of patient health and information generated by one or more encounters in any health care delivery setting
Computerized provider order entry (CPOE)
the process by which the physician or another health care provider, such as a nurse practitioner, physician's assistant, or physical or occupational therapist, directly enters orders for client care into a hospital information system
Acculturation
the process of becoming adapted to a new or different culture
evidence-based practice
the process of systematically finding, appraising, and using research findings as the basis for clinical practice
Constituent/State Nurses Association (C/SNA)
the professional organizational unit member of the American Nurses Association that represents all professional nurses within a state or territory or other defined organizational entity of boundary
Educational mobility
the progressive movement from one type or level of education to another, often based on flexible, self-directed, or advanced placement options
Diagnosis-related groups (DRGs)
the prospective payment systenm is based on ____
to promote health, prevent illness, restore health, alleviate suffering
The ICN says that what four things are the responsibilities of nurses?
Global Burden of Disease (GBD)
a method of quantifying the burden of premature morbidity, disability, and death for a given disease or disease groups
single-payer system
a method of reimbursement in which one payer, usually the government, pays al the health care expenses for citizens, funded by taxes
-patient centered care -teamwork and collaboration -evidence based practice -quality improvement -safety -informatics
what six areas do the QSEN competencies cover
bmi over the 95th percentile for children of the same age and sex
what tells if a child is obese or not?
issues of alternative treatments and acknowledgement of uncertainty
what tests truth-telling
-Health Maintenance Organizations (HMOs) -Preferred Provider Organizations (PPOs) -Point-of-Service plan (POS)
what three plans are managed care plans?
autonomy; beneficence and nonmaleficence; veracity
what three principles have proven to be highly relevant in bioethics?
medical care for crippled children and blind people
what was developed during the great depression?
environmental adaptation theory
what was florence nightingale's theory of practice?
-evidence based practice
what was the research focus in 2000s
it can improve both access to health care quality for minorities and underserved populations
why is diversity in the nursing workforce desirable?
high cost of insurance and lower wages make it difficult for minority groups to rise out of poverty and access health care
why is there limited access to health care insurance and health care itself for minorities?
Physician Assistant
works under the supervision of the MD or DO and performs assessments, procedures, or protocols approved by the physician
quick and dirty
www.google.com , majority of results are newspaper articles and are not providing useful information
advanced
www.google.com/advanced_search ; .gov, .edu, .org
Brute Force
www.neverevents.com
-minimize charges -drive costs down -avoid inappropriate excess of services
what are the goals of the medicare changes that were made in 1983-1990
that people that did not have health insurance were penalized for not having it
what part of the Affordable care act was repealed?
safeguard patient
what should a nurse do, according to the ICN code of ethics, when safety is compromised by others?
-identify patients correctly -improve staff communication -use medicines safely -use alarms safely -prevent infection -identify patient safety risks -prevent mistakes in surgery
TJC national safety goals
Tuberculosis
___ is the leading cause of death for people infected with HIV
1/3
___ of US adults have obesity
115
_____ americans die everyday from opioid overdose
smoking
_____ kills more people than alcohol, AIDS, car crashes, illegal drugs, murders, and suicides combined
science and research information
________ and ___________ ______________ usually requires literature resources that can only be found in scholarly databases such as CINAHL
unemployment
________ is associated in violence
False
culturally incompetent care is less costly than cultural competent care, true or false
Patient-centered care: engagement, safety, and privacy
-All expect value, quality, individual respect, consideration, attention, privacy issues -Patient initiatives for involvement and protection, balance standards and preferences -integrated litigation, medical-nursing errors, focus on safe, competent patient ccare -increased individual responsibility, accountability for learning and practice
Ethics and bioethical concerns
-Alternative solutions to ethical dilemmas; issues regarding diverse beliefs;disputes regarding biotechnology and bioengineering in health care -Many gray zones instead of black and white absolutes, seperate professional practice responsibilities from personal opinions, consequences for competence and safe practice -life and death issues, health care methods
Practice based competency; outcomes and evidence based content
-Learning focused on core practice competency outcomes, professional skills beyond technical psychomotor skills, core practice competencies, multiple conflicting versions -integration of evidence-based standards, research findings into practice, emphasis on critical thinking, problem solving -changes in standards, ensure patient safety
Rapid Knowledge Expansion, increasing use of technology and informatics in education and practice
-choosing the most effective electronic and technology options, - information overload, virtually unlimited global resources, global research opportunities, issues -identifying current and accurate information, material rapidly outdated -expanded expectations, limited time, rapid response expected, little time for reflection
Global Health
-extensive global travel and commerce -illness can arrive on airplane, ship, or bus spread throughout the country -nurses are connected globally through shared networks and technology
world health organization; center for disease control and prevention; louisiana department of health
3 organizations involved in global health
How many RNs in the US?
3.1 million
-patient centered care -teamwork and collaboration -evidence-based practice -quality improvement -safety -informatics
6 QSEN Competencies
Worldview
A ____ provides a cohesive model for life, encourages personal responsibility for living of that life, and it prepares one for making ethical choice encountered throughout life
voluntary; the joint commission
Accreditation is ____ and it is given by the _____
Mary Breckinridge
American Nurse Midwife and founder of the Frontier Nursing Service
arts; sciences; nursing; 126; 136
BSNs require 2 years of ____ and ____, 2 years of ____ courses, and completion of ___-____ credits
Consistency
Can the theory address new entities without having its founding assumptions changed?
inclusiveness
Does the theory include all concepts related to the area of interest?
simplicity
Does the theory provide a road map for replication? Is it simple to follow? Does it make sense?
Relevance
Does the theory relate to the scientific foundation from which its derived? Is it reflective of the scientific base?
Sutures
Egypt used _____
those needing nursing care
In the ICN Code of Ethics, in regards to people, what is the primary responsibility?
competence and a high standard of care
In the ICN code of ethics in regards to practice, what are nurses expected to maintain?
initiate; social needs
In the ICN code, nurses should ___ action to meet the ___ ___ of the public
Victorian
In the ____ image of nursing, nurses were portrayed as drunken and unkept
cooperative
In the code of ethics by the ICN, nurses should have ___ relationships with coworkers.
3rd, 2nd
Louisiana scores ___ in the nation for HIV and ___ in the nation for AIDs
1960s
Medicare and Medicaid were established in the ___
hands; poor infection control and sanitation
Multi Drug Resistance Organisms (MDRO) are often found in healthcare settings. It is spread by ____, caused by ______ _____ ______ ______
Standard 9: Cross-cultural communication
Nurses hall use culturally competent verbal and nonverbal communication skills to identify client's values, beliefs, practices, perceptions, and unique health care needs
clinical skills ; information technology skills
Nurses must combine _____ with _______ to meet a critical need for health information and data management
Standard 2: Critical Reflection
Nurses shall engage in critical reflection of their own values, beliefs, and cultural heritage to have an awareness of how these qualities and issues can affect culturally congruent nursing care.
Standard 3: Knowledge of cultures
Nurses shall gain an understanding of the perspectives, traditions, values, practices, and family systems of culturally diverse individuals, families, communities, and populations they care for, as well as a knowledge of the complex variables that affect the achievement of health and well-being.
Standard 1: Social Justice
Nurses shall promote social justice for all. the applied principles of social justice guide nurses' decisions related to the patient, family, community, and other health care professionals. Nurses develop leadership skills to advocate for socially just policies
-Identify the ethical issues and problems -Identify and analyze available alternatives -Select one alternative -Justify the selection
Steps of the situation assessment procedure
self-awareness; negative moods
The nurse as a leader must have an astute _____ of his or her emotional patterns and an understanding that ______ ______ can have a negative influence on relationships with staff members
Telehealth
Use of telecommunications technology to assess, a diagnose, and, in some cases, treat persons who are at a distance from the health care provider
Prospective Payment System
a method of reimbursement of health care providers in which the total amount of payment for care is predetermined based on the patient's diagnosis -provides for a set-price per diagnosis payment system; encourages increased efficiency in the use of health care services because providers are reimbursed at a predetermined level regardless of how many services are rendered or procedures performed to treat a particular diagnostic category
Sister Callista Roy
adaptation model -client's adaptation to condition using environmental stimuli to adjust perception
Enculturation
adaptation to the prevailing cultural patterns in society
Medicare Modernization Act
added a prescription drug benefit for Medicare enrollees
MRSA: Methicillin/oxacillin- resistant Sstaphylococcus Aureus VRE: Vancomycin Resistant Enterococci ESBLs:Extended Spectrum Betalactamases C-diff: Clostridium Difficile Anicetobacter baumannii MDR-TB- Multi drug resistant tuberculosis CRE-Carbapenem-Resistant Enterobacteriaceae
bacteria and other microorganisms that have developed resistance to antibiotic drugs
marginalized
barriers to mainstream health care include lack of transportation and disrespectful treatment for a group of economically deprived, underserved russian immigrants living in a remote area accessible only by water transportation. A mobile clinic provides blood pressure screening, minor first aid, and blood glucose checks. This group of individuals are best described as ______
Value-based purchasing (VBP)
based on the hospital's scores on the Hospital Consumer Assessment of Healthcare Providers and Systems: the survey that evaluates the patient experience of care
Dorothy E. Johnson
behavioral system model for nursing -separates the psychologic and the physiologic aspects of illness -role of the nurse is to provide support and comofrt to attain regulation of the client's behavior
transculturalism
being grounded in one's own culture but having the skills to be able to work in a cultural environment
integrity
being honest and providing care based on an ethical framework that is accepted in the profession
-cardiovascular disease, diabetes -musculoskeletal disorders, especially osteoarthritis -cancers (endometrial, breast, and colon)
being obese increases risks of:
ethnocentrism
belief in the superiority of one's own ethnic group, culture, or nation
advances in health care and technology
bioethics is a response to __
Pandemic
biologic cause to mass casualty
Narcan or Evzio
brand names of Naloxone
Medicaid
combined federal and state health insurance plan that covers health care for the poor or for the people that work in too small companies
Biculturalism
combining two distinct cultures in a single region
safety for information communication
confidentiality of private health information and the integrity of data
Myra Estin Levine
conservation model. four conservation principles of inpatient client resources
UNAIDS
developed a strategy with 10 targets to reach the end of HIV/AIDS by 2030
TeamSTEPPS
developed as an evidence-based teamwork system aimed at optimizing patient outcomes, helps improve communication and teamwork skills among health care professionals
Dietitian (RD or LD)
dietary assessment, dietary teaching
bioethical dilemmas
dilemmas that pose a choice between perplexing alternatives in the delivery of health care because of the lack of a clear sense of right and wrong
electronic communication and connectivity
electronic communication between health care team members and other care partners, such as radiology and laboratory personnel, and connectivity to the patient record across multiple care settings
results management
electronic reports of laboratory results and radiology procedures with automated display of previous results; electronic consultation reports
decision support
enhance clinical performance by providing reminders about preventive practices, such as immunizations, drug alerts for dosing and interactions, and clinical decision making
value system
entire framework on which actions are based
Accreditation Commission for Education in Nursing (ACEN)
entity that is responsible for the specialized accreditation of nursing education programs, both postsecondary and higher degree, which offer either a certificate, a diploma, or a recognized professional degree
preparedness, mitigation, response, recovery, evaluation
essential to minimizing the impact to individuals and society at large
bioterrorism attacks; pandemic flu
it is recognized by all federal agencies that the most serious knowledge deficit for health care providers is in the area of ______ ______ and ______ _____ events
True
it is required to have a privacy officer that monitors HIPAA. true or false
2002 HIPAA (Health Insurance Portability and Accountability Act)
law that mandates protection of an individuals privacy by health care providers
-authority -resources -capabilities -expertise
lead agencies have the most _____,______, _______,and ______relative to the accomplishment of the specific function
physician
leader of the team, diagnoses and describes treatment interventions for clients; 4 years of medical school and board examinations, can complete post-graduate training including internship, residency, and fellowship training in a specialty area
-cancer -heart disease -stroke -diabetes -homicides -accidents -infant mortality
leading causes of death for minority groups
increasing professional and personal responsibility
lifelong learning to meet professional expectations, certification requirements, increased competency assessment in the workplace -changes in standards for quality care practice -high stress from competing demands of school, home, meeting competency requirements
grassroots lobbying
lobbying activities performed by individual constituents in support of a problem, position, option related to a policy issue
Hildegard E Peplau
made the interpersonal relations model in which it explores the interpersonal relationship between the nurse and the client and identifies the patient's feelings as a predictor of positive outcomes related to health and wellness
Private Health Insurance
maintaining insurance coverage for health care costs through a contract with a health insurance company
non-communicable diseases
makes up for the most deaths
The Essentials for Baccalaureate Education for Professional Nursing Practice
mandates the inclusion of culturally diverse nursing care concepts in the curriculum with attention to cultural, spiritual, ethnic, gender, and sexual orientation diversity
crisis management
measures to identify, acquire, and plan the use of resources needed to anticipate, prevent, and/or resolve an act of terrorism
consequence management
measures to protect public safety and health, restore essential government services and provide emergency relief to governments, businesses, and individuals affected by the consequences of terrorism
resource-based relative value
medicare initiated the _____
Perspective Payment System
medicare moved to a _______ _____ ______
reporting and population health management
meet public and private sector reporting requirements at the federal, state, and local levels; address internal quality improvement initiatives
9.6%
men now make up ___% of nurses
Pay for Performance (P4P)
method of payment in which medicare and private insurance reimburse providers based on quality of care
Root Cause Analysis (RCA)
method of problem solving that helps to identify how and why an event occurred
-protect children and youths from tobacco -prevent them from starting -offer tobacco users to quit -protect nonsmokers from exposure to second hand tobacco smoke -warn people about the dangers of tobacco -regulate tobacco products -ban tobacco advertising and promotion
what should be done to help with smoking?
human dignity
valuing and respecting all colleagues, regardless of background
interpersonal violence
violence against another
self-directed violence
violence against yourself
businesses, churches, and schools
violence now happens mostly in ___,____,&____
Sojourner Truth
was a nurse to a family that enslaved her and she was an advocate for women's rights
-cardiovascular disease -diabetes -musculoskeletal disorders -some cancers (endometrial, breast, colon)
what are health consequences that come along with obesity
-suspension of large public gatherings -school closure -social distancing
what are limitations placed on people with the flu?
-inadequate educational preparation, especially in the sciences -financial costs -inadequate career counseling -lack of valuing the role of nursing by some cultures -better recruitment efforts by other disciplines
what are some factors inhibiting minority members from attaining a career in nursing?
-Sigma Theta Tau International -ANA -Ocology Nurses Society
what are some nursing organizations that fund nursing research?
increasing number of immigrants, minority populations will become the majority population, growth in the number and proportion of older adults is increasing at an unprecedented rate, longer lifespans and aging baby boomers
what are some population trends?
WK Kellogg Foundation and the Robert Wood Johnson foundation
what are some private foundations that fund nursing research
residential segregation, substandard housing, unemployment, poor physical and mental health, poor self-image
what are some things that minority groups deal with?
-NP -Clinical Nurse Specialist -CRNA -Certified Nurse Midwife
what are the 4 types of advanced practice?
-reformed the british army medical corps -improved sanitation in india -improved public health in great britain -used stats to document health outcomes -developed organized training for nurses
what are the 5 things Florence Nightingale did?
patient is the source of control, patient values, patient preferences, diverse cultures, ethnic, and social backgrounds, respect and encourage individual expression
what are the characteristics of the QSEN patient centered care competency?
-health and information data -results management -order entry and order management -decision support -electronic communication and connectivity -patient support -administrative processes -reporting and population health management
what are the core functionalities for the EHR system as recommended by the IOM?
-Inclusiveness -Consistency -Accuracy -Relevance -Fruitfulness -Simplicity
what are the criteria for theory acceptance?
-Chemical -Biologic -Radiologic -Nuclear -Explosive
what are the different tyes of agents used by terrorists?
-hypothesis -method -data collection -results -evaluation
what are the five steps of the Scientific process?
Veracity, paternalism, autonomy, accountability
what are the four challenges that are involved in ethical health care?
Level 1- systematic review of RCTs (randomized controlle trials) or nonrandomized trials Level 2- a single RCT, or a single nonrandomized trial Level 3- a systematic review of correlational or observational studies Level 4- Single observational or correlational study Level 5- systematic review of a descriptive/qualitative/physiologic study Level 6- Single descriptive/qualitiative/physiologic study Level 7- Opinions of authorities, expert committees
what are the levels of evidence?
-insurance premium -deductibles -copayments
what are the out of pocket expenses for health insurance?
-Care provider -Educator and counselor -Client advocate -Change agent -Leader and manager -Researcher -Coordinator of the interprofessional health care team
what are the professional nursing roles?
-age 65 or older who are eligible for social security -other disabilities
what are the requirements for people meeting the criteria for medicare?
-3-5 million cases severe illness -290,000-650,000 deaths -10% of louisiana population affected each year -During outbreak 14-40% become ill in LA
what are the stats regarding influenza?
-non-communicable diseases -communicable, maternal, perinatal, and nutritional conditions -injuries
what are the three categories of health issues
-quality -scientific approach -all one team
what are the three cornerstones of quality management?
-Medicare -Medicaid -Veterans Administration
what are the three government health programs
-flight nurse -travel nurse -hospice nurse
what are three examples of non-traditional nursing?
-systematic reviews -preappraised literature -studies from peer reviewed journals
what are three reliable sources?
care coordination, patient care navigator, transition care coordinators
what are three rising titles of nursing that ensure positive patient outcomes and maximizing reimbursement
-patient safety -patient rights -patient treatment -infection control
what areas does the joint commission cover for accreditation?
freedom; informed consent
what concepts are grounded in the principle of autonomy?
lack of cost consciousness
what contributed to increased cost?
it allowed people to be on their parents' insurance until they were 26
what did the Affordable Care Act do?
ensuring positive patient outcomes and maximizing reimbursement
what do nurses have a very strong role in?
an imbalance of beneficence or maleficence
what do the most common bioethical questions come from?
Health Information Portability and Accountability Act
what does HIPAA stand for
-Population -Intervention or Interest area -comparison -outcome -time
what does PICOT stand for?
-Safe -Timely -Effective -Efficient -Equitable -Patient-centered
what does STEEEP stand for
-Strategies and -Tools to -Enhance -Performance and -Patient -Safety
what does TeamSTEPPS stand for
increase length of stay, costs, and mortality
what does resistant bacteria cause for a patient?
it eliminates lost orders and illegible handwriting, generates related orders automatically, monitors duplicate or contradictory orders, reduces time to fill orders
what does the CPOE do?
-communication with nurses -communication with doctors -responsiveness of hospital staff -pain management -communication about medicines -cleanliness and quietness of hospital environment -discharge information
what does the Hospital Consumer Assessment of Healthcare Providers and Systems (HSAHPS) include in its patient satisfaction survey?
reduces costs, aids in health and patient care
what does the health information technology help?
giving the highest wuality health care to the people with the highest socio-economic status and the lowest wuality health care to the people with low socioeconomic status
what does the united states have a history of regarding health care?
homelessness, joblessness, poverty
what is a social/economic change happening with america today?
prolonging life with technology
what is cost a consequence of?
voice, handwriting, biologic characteristics
what is pattern recognition?
bioethical dilemma
what is the question of pro life or pro choice an example of?
-hate -contempt -tolerance -respect -celebration
what is the range of attitudes towards ethnic groups?
-alcoholic hepatitis -cirrhosis, which is among the 15 leading causes of death -Hepatitis C virus, the worsening of liver function and interference with medications used to treat this condition
what liver diseases does alcohol cause
Centers for Medicare and Medicaid Services (CMS)
what organization regulates quality?
Institution of Medicine
what organization was called upon in 2009 to address the issues related to the community response to major disasters?
-devleoping care plans/discharge plans -providing eductation to make informaed decisions -establishing "family advisory councils" to engage decision making -incorporating user friendly technology to support patient education
what outlines patient centered care?