Test 1
INTRODUCTION TO MODERN NURSING Florence Nightingale 1820-1910 Regarded as one of the early ______ of _____ ____. Instrumental in the _____ ____ in _____ ____. Provided care to _____ ____. Proved that a group of ____ _____, informed about health and the ways to promote it, could improve ______ ____ in patients. Successfully established a number of _____ ____, including __ _____ ____ in London.
1. forerunners of professional nursing 2. Crimean War in October 1854 3. British soldiers 4. educated women 5. health outcomes 6. British hospitals 7. St. Thomas Hospital
Rural hospitals 1. Loan _____ for doctors who work in rural areas 2, Many people living below ___ ___ 3. Low ____ levels 4. More ____ 5. ____ differences
1. forgiveness 2. poverty line 3. education 4. isolated 5. Cultural
What are the 10 ANA identified standards of professional performance?
1. ethics 2. education 3. Evidence-Based Practice and Research 4. Quality of practice 5. Communication 6. Leadership 7. Collaboration 8. Professional Practice Evaluation 9. Resources 10. Environmental Health
Healthcare Regulation and Reform - UR committees are within ____ hospital - _______→ set rate of cost - Managed care → healthcare systems that receives a ___-_____ ____ for every patient
1. every 2. Diagnosis-related groups (DRGs) 3. pre-determined capitation
ANA STANDARDS OF NURSING PRACTICE - Outcome Identification The registered nurse identifies ____ ____ for a plan _____ to the patient or the situation
1. expected outcomes 2. individualized
ANA STANDARDS OF NURSING PRACTICE - Implementation: Prescriptive Authority and Treatment The ____ _____ _____ ____ uses prescriptive authority, procedures, referrals, treatment, and therapies in accordance with state and federal laws and regulations.
advanced practice registered nurse
Clara Barton was the Founder of ___ ____ ___
american red cross
ANA STANDARDS OF NURSING PRACTICE - Evaluation The registered nurse evaluates progress toward ____ of ____
attainment of outcomes.
ANA STANDARDS OF NURSING PRACTICE - Implementation: Care Coordination The registered nurse coordinates _____ _____
care delivery
The nursing process is the foundation of ____ ____ ____
clinical decision making
Standards of practice describe a ____ level of nursing and Goes hand in hand with the ___ ____ ___
competent nursing process model
The registered nurse attains knowledge and competency that reflects current nursing practice.
eDUCATION
Florence Nightingale was one of the earliest _____ and wrote ____ ___ ____
epidemiologists "Notes on Nursing"
ANA STANDARDS OF NURSING PRACTICE - Implementation: Consultant The _____-_____ _____ ____ or ____ ___ ____ ____ provides consultation to influence the identified plan, enhance the abilities of others, and effect change
graduate level-prepared specialty nurse or advanced practice registered nurse
ANA STANDARDS OF NURSING PRACTICE - Implementation The registered nurse implements the _____ ____
identified plan
_____ _____ (______): emphasized interpersonal relationship between nurses and patients
1. Hildegard Peplau (1952)
The registered nurse practices in an environmentally safe and healthy manner.
. Environmental Health
Nursing responds to the health care needs of _____, which are influenced by __3__ variables of a specific ___.
1, society 2, economic, social, and cultural 3. era
Benner's stages of nursing proficiency - Competent A nurse who has been in the same clinical position for # to # years. This nurse understands the _____ and ____ ____ required by the type of patients (e.g., surgical, oncology, or orthopedic patients). He or she is a competent practitioner who is able to _____ nursing care and establish ____-____ ____. In this phase the nurse has usually had experience with all types of ______ _____ required by this specific group of patients.
1. 2 to 3 years 2. organization and specific care 3. anticipate 4. long-range goals 5. psychomotor skills
PROFESSIONAL REGISTERED NURSE EDUCATION Registered nurse education • _____ degree • _____ degree Graduate education • Master's degree, _____ ____ ___ • Doctoral degrees—__2__ Continuing and in-service education
1. 2-year associate's 2. 4-year baccalaureate 3. advanced practice RN 4. PhD (research) DNP—Doctor of Nursing Practice (practice)
HEALTH CARE REGULATION AND REFORM Patient Protection and Affordable Care Act - _____ to health care for ____ - Reducing ____ - Improving ___ - Provisions include --> _____ industry reforms --> Increased ____ for ____ programs --> Improved ____ for ____
1. Access ... all 2. costs 3. quality 4. Insurance 5. funding for public 6. coverage for children
ANA STANDARDS OF NURSING PRACTICE - What are the 4 parts of implementation?
1. Care coordination 2. health teaching and promotion 3. consultation 4. prescriptive authority and treatment
SCIENCE AND ART OF NURSING PRACTICE- Nursing requires • _____ knowledge and practice standards • ____ and _____ approach • ____ ____
1. Current 2. Insightful and compassionate 3. Critical thinking
_____ ____ (______): nurses should do for a person only those things that the person cannot do without assistance
1. Dorthea Orem (1959)
TRENDS IN NURSING: - _____-____ practice - ______ and ____ ____ for ____ (_____) - Impact of ____ ____ - _____ics - ____ ____ of nursing - Impact of nursing on ____ and ___ ____
1. Evidence-based 2. Quality and Safety Education for Nurses (QSEN) 3. emerging technologies 4. Genomics 5. Public perception 6. politics and health policy
HUNTER BELLEVUE SCHOOL OF NURSING The nation's first nursing school based on ____ ____ principles, the ___ _____ for _____, opened at Bellevue in ____. Sister ____ ____ of the ____ ____ ____ in London was the first Superintendent.
1. Florence Nightingale's 2. Training School for Nurses 3. 1873 4. Helen Bowdin 5. All Saints Sisterhood
NURSING PRACTICE ______ Overseen by State Boards of Nursing Regulate scope of nursing practice Protect public health, safety, and welfare Written and passed by ____ legislators They are there to protect the ____ act; shields the public from ____ and ___-____ nurses
1. Nurse Practice Acts (NPAs) 2. state 3. public 4. unqualified and non licensed
Nursing's largest and leading professional nursing organization • 1896 - ____ ____ ___ of the United States and Canada • ____ - became the American Nurses Association
1. Nurses Associated Alumnae 2. 1911
Quality and Safety Education for Nurses (QSEN) includes
1. Patient-centered Care 2. Teamwork and Collaboration Function 3. Evidence-Based Practice 4. Quality Improvement 5. Safety 6. Informatics
Preventive and primary health care 1. ______ care focuses on improving health outcomes for an entire population 2. 80-90% of care falls under ____ care
1. Primary 2. primary
CAREER - What type of careers can nurses have?
1. Provider of care 2. advanced practice registered nurses 3. nurse educator 4. nurse administrator
NURSING AS A PROFESSION 1. patient-centered care 2. professionalism - administer quality care - be responsible and accountable 3. Health care advocacy groups - _____ _____ _____ _____ (___)Future of Nursing: Campaign for Action - _____ ___ ____ (___)publication on The Future of Nursing
1. Robert Wood Johnson Foundation (RWJF) 2. Institute of Medicine (IOM)
CHALLENGES TO HEALTH CARE 1. ______ patients 2. _____ health care costs while maintaining ____-____ care for patients 3. Improving _____ and _____ for more people 4. Encouraging _____ behaviors 5. _____ hospital discharges result in more patients needing ____ ____ or ____ ____
1. Uninsured 2. Reducing ... high-quality 3. access and coverage 4. healthy 5. Earlier ... nursing homes or home care
RESTORATIVE CARE 1. Serves patients recovering from an ____ or ____ illness/disability 2. Helps individuals regain ____ function and enhance ___ of ____
1. acute or chronic 2. maximal ... quality of life
HEALTH CARE REGULATION AND REFORM Utilization review (UR) committees - Review ____, _____ testing, and _____ ordered by physicians who cared for patients receiving ____
1. admissions, diagnostic, and treatments 2. Medicare
What are the 5 steps of evidence-based medicine?
1. ask a clinical question 2. acquire the best evidence 3. appraise the evidence 4. apply the evidence 5. assess your performance
ANA STANDARDS OF NURSING PRACTICE - Diagnosis The registered nurse analyzes the _____ ____ to determine the ____ or ____
1. assessment data 2. diagnoses or issue
What are the 6 professional responsibilities and roles?
1. autonomy and accountability 2. caregiver 3. advocate 4. educator 5. communicator 6. manager
New York Governor Andrew Cuomo signed a bill (2017) requiring all nurses to obtain a ____ ____ in nursing within __ ____ of initial licensure.
1. baccalaureate degree 2. 10 years
FLORENCE NIGHTINGALE NOTES ON NURSING, 1859 Principles of Nursing Practice The duty of a nurse is to put the patient in the ____ _____ for _____ to act upon him or her. Five essential components to an optimal healing environment: __5__
1. best condition for nature 2. pure air, pure water, efficient drainage, cleanliness, and light
SIX ESSENTIAL FEATURES OF CONTEMPORARY NURSING PRACTICE -Provision of ____ ____ -Attention to the ____ of ____ ____ -Integration of _____ ____ with knowledge of the patient's ____ ____ -Application of _____ through the use of ____ _____ -______ of professional knowledge through ____ ____ -Influence on _____ and ____ ___ to promote ____ ____
1. caring relationships 2. range of human illness 3. objective data ... subjective experience 4. knowledge ... critical thinking 5. Advancement .... scholarly inquiry 6. social and public policy... social justice
Role of ANA • Developing and maintaining nursing's ____ of _____; • Developing and maintaining the ____ and ____ of nursing practice; • Supporting the development of nursing _____ and ____; • Establishing the ____ ____ of professional practice; • Defining professional role _____; • Articulating nursing's _____ to society, including government ____.
1. code of ethics 2. scope and standards 3. theory and research 4. educational requirements 5. competence 6. accountability ... advocacy
WHY IS DEFINING NURSING IMPORTANT? If we cannot name it, we cannot _____ it, _____ it, ______ it, _____ it, or put it into ____ ____.
1. control 2. finance 3. research 4. teach 5. public policy
ANA STANDARDS OF NURSING PRACTICE - Assessment The registered nurse collects comprehensive ____ pertinent to the patient's _____ and/or the ____
1. data 2. health and/or the situation
Quality Improvement Use ____ to monitor the ____ of ____ ____ and use improvement methods to ____ and ____ changes to continuously improve the ____ and ____ of health care systems
1. data 2. outcomes of care processes 3. design and test 4. quality and safety
Benner's stages of nursing proficiency - Expert A nurse with ____ experience who has an ____ grasp of an ____ or _____ clinical problem. This nurse is able to _____ in on the problem and focus on ____ ____ of the situation. He or she is skilled at identifying both _____-_____ problems and problems related to the ____ ____ ____ or perhaps the needs of the ____ ____.
1. diverse 2. intuitive 3. existing or potential 4. zero 5. multiple dimensions 6. patient-centered 7. health care system 8. novice nurse
LICENSURE: Regardless of _____ preparation, the ____ for RN licensure is exactly the ____ in every state in the United States. This provides a ____ ____ ____ base for nurses. Other requirements for licensure such as ____ ____ ____vary from ___ to ___. Primary purpose is to ____ the ____
1. educational 2. examination 3. same 4. standardized minimum knowledge 5. criminal background checks 6. state to state 7. protect the public
WHY IS DEFINING NURSING IMPORTANT? 1. Having a uniform definition of nursing is essential to provide a _____ for nursing ____ of ____. 2. It clarifies the _____ of the profession and explicates the _____ that nurses do. 3. It guides the _____ ______ of aspiring practitioners and guides _____ and _____ development. 4. It guides ____ ____ and _____ (local, state, national levels). 5. ______ nurses from other healthcare professionals.
1. framework .... scope of practice 2. purpose .... work 3. educational preparation... research and theory 4. policy makers and politicians 5. Differentiates
INSTITUTE OF MEDICINE (IOM) Nurses need to: 1. Practice to the ____ ____ of training 2. Achieve _____ levels of _____ through an education system that provides ____ progression 3. Become full ____ with physicians and other health care providers in redesigning the health care system 4. Improve data ____ and the ____ _____ for effective workforce planning and policy making
1. full extent 2. higher ... education ... seamless 3. partners 4. collection ... information infrastructure
Safety Safety minimize risk of ____ to _____ and ____ through both _____ ____ and ____ ____
1. harm to patients and providers 2. system effectiveness and individual performance
EMPHASIS ON POPULATION WELLNESS Health Services Pyramid - Managing ____ instead of ____ - Emphasis on ____ - ____-____ programs
1. health instead of illness 2. wellness 3. Injury-prevention
Secondary and Tertiary care - Once your in the ____, cost goes up - _____ care (ie psych floors, ICU) is the most expensive → ______ of nurses to patients is low, so cost go up
1. hospital 2. Tertiary ... ratio
Nursing standards provide the guidelines for ____ and ____ nursing care. ____ _____ ____ deal with issues of concern to specialist groups within the nursing profession. Nurses are becoming more ____ sophisticated and, as a result, are able to increase the influence of nursing on ____ ___ ____ and ____
1. implementing and evaluating 2. Professional nursing organizations 3. politically 4. health care policy and practice
Health promotion programs lower overall costs 1. Reduces ____ of ____ 2. Minimizes ____ 3. Reduces the need for more ___ ___
1. incidence of disease 2. complications 3. expensive resources
Informatics Use _____ and _____ to ______, manage _____, mitigate ____, and support ____ ____
1. information and technology 2. communicate 3. knowledge 4. error 5. decision making
PhD generally studies ____ and ____ DNP → they do projects and generally ___ ____
1. longer and researches 2. QI projects
PROFESSIONAL NURSING ORGANIZATIONS -Address ____ ____ -Present ____ ____ -Publish ____ -Student organizations --> _____ --> _____
1. member concerns 2. educational programs 3. journals 4. National Student Nurses Association (NSNA) Canadian Student Nurses Association (CSNA
Benner's stages of nursing proficiency - Proficient A nurse with _____ than #-# years of experience in the same clinical position. This nurse perceives a patient's clinical situation as a ____, is able to assess an ____ situation, and can readily transfer knowledge gained from _____ _____experiences to a situation. This nurse focuses on ____ ____ as opposed to ____ and ____ ____.
1. more than 2 to 3 years 2. whole 3. entire 4. multiple previous 5. managing care 6. managing and performing skills
Benner's stages of nursing proficiency - Novice Beginning ____ _____ or any nurse entering a situation in which there is no previous level of _____ (e.g., an experienced operating room nurse chooses to now practice in home health). The learner learns via a ______ set of rules or procedures, which are usually ____ and ____.
1. nursing student 2. experience 3. specific 4. stepwise and linear
ETYMOLOGY OF THE WORD "NURSE" The word "nurse" is derived from the Latin "______" meaning to _____. Originates from the Latin noun "______" defined as _____ ____.
1. nutrire 2. nourish 3. nutrix 4. nursing mother
Patient Centered Care Recognize the ____ or _____ as the source of _____ and ___ ____ in providing compassionate and coordinated care based on respect for patient's __3__
1. patient or designee 2. control and full partner 3. preferences, values and needs
RESTORATIVE CARE: REHABILITATION 1. Includes __4__ 2. Begins on ____ 3. Focuses on _____ complications 4. Maximizes patient ____ and ____
1. physical, occupational, and speech therapy, and social services 2. admission 3. preventing 4. function and independence
What are the five levels of the health services pyramid in order from base to top?
1. population-based health care services 2. clinical preventive services 3. primary health care 4. secondary healthcare 5. tertiary healthcare
What are the 6 healthcare services?
1. preventive 2. primary 3. secondary 4. tertiary 5. restorative 6. continuing
ANA definition of nursing: "Nursing is the __3__ of health and abilities, _____ of illness and injury, alleviation of suffering through the _____ and ____ of human response, and _____ in the care of individuals, families, communities, and populations."
1. protection, promotion, and optimization 2. prevention 3. diagnosis and treatment 4. advocacy
PRELUDE TO MODERN AMERICAN NURSING (17TH - 19TH CENTURY) 1. Deeply embedded in _____ 2. One of the first known nurses, _____, was mentioned in Romans 16:1. (55 AD) She was a deaconess and ___ ____ sent her to _____ as the first _____ _____. (Nutting & Dock, 1907) 3. Early nurses were a part of ____ ___
1. religion 2. Phoebe.... St Paul... Rome... visiting nurse 3. religious orders
A code of ethics is the philosophical ideals of ____ AND ____ that define principles used to ____ ____. It is important for you to incorporate ____ ___ values and ethics into your ____ . Ask yourself: How do your ethics, values, and practice compare with ____ ____?
1. right and wrong 2. provide care 3. your own 4. practice 5. established standards
Benner's stages of nursing proficiency - Advanced Beginner A nurse who has had _____ level of experience with the situation. This experience may only be _____ in nature, but the nurse is able to identify ______ ____ or _____ of nursing care.
1. some 2. observational 3. meaningful aspects or principles
SECONDARY AND TERTIARY CARE 1. Secondary health care- provided by a ____ or ____ upon referral by a ____ health care provider- need great knowledge, skill or equipment 2. Tertiary health care- ____ ____ care; usually on referral from ____; 3. These are both used when the _____ provider cannot offer services for whatever reason OR if ____ ___ is needed 4. Both are typically _____
1. specialist or agency... primary 2. specialized consultive ... secondary 3. primary ... intensive nursing 4. expensive
CERTIFICATION -RNs may choose to work toward certification in a ___ ___of nursing practice. -____ ____ requirements are set, based on the certification the nurse seeks. -National nursing organizations such as the ____ have many types of ____ to enhance your career such as certification in medical surgical or geriatric nursing. -After passing the initial examination, you maintain your certification by ongoing ____ ____ and ____ or ____ _____.
1. specific area 2. Minimum practice 3. ANA ... certification 4. continuing education and clinical or administrative practice
ANA STANDARDS OF NURSING PRACTICE - Planning The registered nurse develops a plan that prescribes _____ and ____ to attain _____ _____
1. strategies and alternatives 2. expected outcomes
Changes in society such as increased _____, new demographic _____, ____, health _____, and the ____ and ____ ____ movements lead to changes in nursing.
1. technology 2. patterns 3. consumerism 4. promotion 5. women's and human rights
Dorthea Orem Connected with the ____ of ____ ____. This has _____ over the years. People have done a great job of keeping her model and upping it to today ___ ____ ____ talks a lot about self care and management
1. theory of self care 2. evolved 3. Dr. Barbara Regal
RESTORATIVE CARE: HOME HEALTH CARE 1. Provision of medically related services and equipment to patients and families in their homes for health maintenance, education, illness prevention, diagnosis and treatment of disease, palliation, and rehabilitation. 2. Involves ____ of services. 3. Focuses on patient and family _____. 4. Usually reimbursed by _____(such as ____ and ____ in the United States), _____ ___, and ____ ____.
2. coordination 3. independence 4. government (medicare and medicaid), private insurance, and private pay
HEALTH CARE REGULATION AND REFORM Regulatory and competitive approaches - Professional standards review organizations (PSROs) --> Created to review the __3__ of hospital care provided through _____ and ____
2. quality, quantity, and cost 3. Medicare and Medicaid
SECONDARY AND TERTIARY CARE (____ ____) 1. Focus: ____ and ____ of disease 2. _____ _____ is the most common and expensive service of the health care delivery system 3. _____ of care by _____ contributes to high costs
ACUTE CARE 1. Diagnosis and treatment 2. Disease management 3. Postponement .. .uninsured
What are the six standards of nursing practice?
Assessment Diagnosis Outcomes identification Planning Implementation Evaluation
Give 4 examples of advanced practice registered nurse
Clinical nurse specialist Certified nurse practitioner Certified nurse midwife Certified registered nurse anesthetist
The registered nurse collaborates with health care consumer, family, and others in the conduct of nursing practice
Collaboration
The registered nurse communicates effectively in all areas of practice
Communication
The nurse has been working in the clinical setting for several years as an advanced practice nurse. However, the nurse has a strong desire to pursue research and theory development. To fulfill this desire, which program should the nurse attend? Doctor of Nursing Science degree (DNSc) Doctor of Philosophy degree (PhD) Doctor of Nursing Practice degree (DNP) Doctor in the Science of Nursing degree (DSN)
Doctor of Philosophy degree (PhD)
The registered nurse practices ethically
Ethics
The registered nurse integrates evidence and research findings into practice.
Evidence-Based Practice and Research
RESTORATIVE CARE: EXTENDED CARE _______ _____ ____: Provides intermediate medical, nursing, or custodial care for patients recovering from acute illness or disabilities
Extended care facility
Primary care (____ ____) 1. Focuses on ___ ____ ___ 2. Requires ____
Health Promotion 1. improved health outcomes 2. collaboration
RESTORATIVE CARE: EXTENDED CARE ______ _____ ____ ____: Provides care for patients until they can return to their community or residential care location
Intermediate care/skilled nursing facility
The registered nurse demonstrates leadership in the professional practice setting and the profession
Leadership
____ ____ (1841- 1930) First professionally trained American nurse.
Linda Richards
_____ _____ (graduated _____) First registered African American nurse to study and work in the United States.
Mary Mahoney (1879)
The nurse prescribes strategies and alternatives to attain expected outcome. Which standard of nursing practice is the nurse following? Assessment Diagnosis Planning Implementation
Planning
The registered nurse evaluates her or his own nursing practice in relation to professional practice standards and guidelines, relevant statutes, rules, and regulations
Professional Practice Evaluation
A nurse teaches a group of nursing students about nurse practice acts. Which information is most important to include in the teaching session about nurse practice acts? Protects the nurse Protects the public Protects the provider Protects the hospital
Protects the public
Hildegard Peplau did ______ nursing
Psychiatry / psychiatric
The registered nurse contributes to quality nursing practice
Quality of Practice
The registered nurse uses appropriate resources to plan and provide nursing services that are safe, effective, and financially responsible
Resources
"_____ ____" are errors in medical care that are clearly identifiable, preventable, and serious in their consequences for patients, and that indicate a real problem in the safety and credibility of a health care facility
never events
Nurse educator → nurses that _____ you at the hospital
onboard
ANA STANDARDS OF NURSING PRACTICE - Implementation: Health Teaching and Promotion The registered nurse uses strategies to ___ ___ and a ____ ___
promote health and a safe environment
Preventive Care reduces and controls ___ ___ for ____
risk factors for disease
SCIENCE AND ART OF NURSING PRACTICE - What are the Benner's stages of nursing proficiency
• Novice • Advanced beginner • Competent • Proficient • Expert
