Week 3 Day 3 - Informatics Education Professionalism, Legal, Ethics
*Stage ___ : "________ Beginner " -Demonstrates basic skills *BUT* -STILL needs guidance & support Novice to Expert Stages
2, Advanced
*Stage __: "_____________" -Advanced decision-making, knowledge, resourcefulness, flexibility, & problem-solving. Novice to Expert Stages
4, Proficient
*Stage ___ : "_________" -Can plan + make decisions -Performs job responsibilities efficiently Novice to Expert Stages
3, Competent
*Stage __: "_________" -Role models deep knowledge & skills. -Teaches others -Multitasks effortlessly & fluently Novice to Expert Stages
5, Expert
____________ and Assignment Issues: •Short Staffing -Legal problems occur if there's not enough nurses to provide care. •Floating -Based on census load & patient acuities. (acuity means level of patient need from a nurse/intensity of care needed) •Healthcare Providers' Orders -Nurses follow orders UNLESS they believe an order was given in error OR could be harmful.
Abandonment
Health Literacy is the cognitive & social skills that determines: *Motivation & _______ of a Person to: -Access -____________ -Use Info ***To Promote & Maintain Health.
Ability, Understand
__________ is responsibility to expected standards of care. Nursing Professionalism
Accountability
_____________ in Nursing means: *Ability & willingness to take responsibility for YOUR actions *Accept consequences of behavior *Can be viewed as: -Hierarchic -Individual Level (Reflected in ethical integrity) -Institutional or Professional Level (Reflected in Philosophy Statement & Objectives of Department) -Societal Level (Reflected in ****Legislated Nurse Practice Acts*) ***A LEGAL OBLIGATION w/ moral & ethical commitment to do the right thing, EVERY time, and in EVERY situation. Comparison of Nurse Accountability VS Responsibility
Accountability
•Americans with Disabilities Act (ADA) -Protects rights of people w/ physical or mental disabilities •Emergency Medical Treatment & ______ _____ Act -A pt. must be treated at the hospital/emergency they enter & can't be transferred (private to public care) (w/out proper screening, written consent from pt. after informed/risks, or it would benefit the pt. No "pt. dumping" •Mental Health Parity Act as Enacted Under PPACA -Strengthens mental health services *Federal Statutory Issues in Nursing Practice
Active Labor
________ __________ includes: •Living wills • Healthcare proxies or Durable Power of Attorney for Healthcare Federal Statutory Issues in Nursing Practice
Advance Directives
________ is selfless concerns & actions for the benefit of others
Altruism
*In Teaching & Learning, nurses reach an _________ level of nursing practice by actively engaging w/ both: 1.) ___________ Learning Opportunities & 2.) Formal Education Programs Professionalism
expert, Jobsite
___________ is a nonverbal form of communication that evokes a response from others. Nursing Professionalism
Appearance
Implementation of a teaching plan should include: •Maintain attention + participation in Learning •Build on Existing Knowledge •Select Teaching _________ •Incorporate Teaching into Nursing _______
Approach, Care
Processing an Ethical Dilemma: •Step 1: _____ if it's an ethical dilemma •Step 2: _______ ALL relevant info •Step 3: _______ values •Step 4: ________ the problem. •Step 5: ___________ courses of action •Step 6: ___________ the outcome. •Step 7: ___________ the action.
Ask, Gather, Clarify, Verbalize, Identify, Negotiate, Evaluate
_______ is the right of self-determination. Freedom & Authority to: -Make decisions -Take action consistent w/ expertise -Apply professional knowledge to patient care & clinical decision-making -Think critically related to patient's care
Autonomy
___________ means a commitment to include patients in decisions. -Support patient involvement Health Ethics Basic Terms
Autonomy
The _______ governs nursing practice
BRN
*Stage 1: Novice = _________ -Little to no experience Novice to Expert Stages
Beginner
______________ factors play a large role in the nurse's identification as a professional. Nursing Professionalism
Behavioral
___________ means taking positive actions to help others. -Doing or producing Good -Act in the best interest of the patient -Moral obligation to act for the benefit of others Sentence Examples: -His beneficence was well known. -Doctors w/out Borders is a beneficent organization that provides free healthcare to developing countries. -Even tho, the beneficent nurse's shift was over, she stayed & visited w/ some elderly patients. -The beneficent institution maintains a scholarship fund for needy students. Health Ethics Basic Terms
Beneficence
___________ Interventions MUST show a positive attitude & compassion. This includes: -Cultural awareness (for patient's needs) -Recognizing that Nurses are crucial to patient care.
Caring
___________ Interventions include compassion & awareness of + concern for the suffering of another. Nursing Professionalism
Caring
________ and ________ Law Issues in Nursing Practice: •Torts •Intentional: -Assault -Battery -False imprisonment •Quasi-intentional torts -Invasion of privacy -Defamation of character ~Slander (spoken defamation) ~Libel (written defamation) •Unintentional torts •Negligence •Malpractice
Civil and Common
_____________ means respectfully working with others to achieve a common goal. Nursing Professionalism
Collaboration
____________ is achieved by working respectfully & communicating fluently w/ other healthcare team members, -Nurses must display __________ collaboration skills.
Collaboration, professional
W/ ______________ nurses show effectiveness thru strict use of universally accepted standards of care & _________. Professionalism
Competence, EBP
Health literacy for the patient includes: -Reading + -Mathematics + -_________________ + -Decision-Making & Functioning Skills w/ regard to health care. How Nurses Identify Educational needs of the Patient
Comprehension
Learning is a change in Human _______, or ________, that persists over a period of time & cannot be purely attributed to growth. -Results In: Permanent change in knowledge or understanding
Disposition, Capability
In _________ nurses engage in consistently ethical behavior & demonstrate integrity. Nursing Professionalism
Ethics
________ is key to professionalism & shown by: 1.) Following accepted nursing standards 2.) Consider Ethical Significance in your actions 3.) Nurses protect patients & healthcare team 4.) Demonstrate integrity (what you do when no one is watching)
Ethics
*_________ Statutes that Impact Nursing Practice 1.) Patient Protection & Affordable Care Act -Increased HC Access -Consumer Rights & Protections -Affordable Coverage (tax credits & Rate Hike Restrictions, Lowered Med Costs, & Care Limits-life & annual) -Quality of Care Preventative Screenings, Pre-Existing Conditions, Increased Insurance Choices -Expanded Medicare (for at-risk pop.) -Addressed Billing Fraud -Uninsured: High Cost of Coverage & No Employer Coverage (main reasons), Older Adults Ineligible for $ Assistance, Families w/1 Working Member (low income) Adults under 65. -Continues to Change to Meet Needs 2.) Emergency Medical Treatment & Active Labor Act 1986 -Prohibits Patient Transfer (from private to public hospitals) WITHOUT correct screening/stabilization. -Prevents "Patient Dumping" -Ensures patients entering hospital or emergency care get proper treatments -Exceptions: A patient REQUESTS transfer or discharge IN WRITING AFTER receiving info about risks of transfer -OR- if Provider certifies benefits outweigh the risks. 3.) Health Insurance Portability and Accountability Act -Rights & Protections -Penalties for Non-Compliance -Privacy & Confidentiality -Right to Health Record (+changes w/mistakes or incomplete info) 4.) Health Information Technology Act (HITECH) -Expands HIPAA principles of to electronic data 5.) Americans with Disabilities Act -Protects rights of people w/ physical or mental disabilities -Prohibits discrimination & ensures equal opportunities -Reasonable Accommodations in: employment, state & local government services, public accommodations, commercial facilities, & transportation 6.) Mental Health Parity and Addiction Equity Act -Requires insurance companies to cover mental health & substance use disorder (SUD) treatment. 7.) Patient Self-Determination Act (1991) -Requires health institutions to give WRITTEN info to pts. about: -Rights & Decisions for Care, which includes: RIGHT to REFUSE treatment & formulate an ADVANCE DIRECTIVE -Advance Directives = patient desires (before, during, & after death) -Cardiac or Respiratory Arrest wishes (for CPR etc./Provider HAS TO sign) -Copy of patient's Durable Power of Attorney for Health Care (DPAHC) -DPAHC should include designated person for decisions (after provider confirms pt. decision capacity status) 8.) Uniform Anatomical Gift Act -18/yrs or older has right to make an organ donation 9.) The Omnibus Budget Reconciliation Act (OBRA 1987) -Established min. standards of care for nursing facilities to receive payment from Medicare & Medicaid -Improved quality of life (older adults) -Reduced use of restraints (last resort to protect patient or others) must have written order. Must document & reassess) -Long-term pt. rights (voting, 30 notice of discharge, care plan autonomy, private visitors) -Set Minimum Standards for: Nursing Assist. Training Staffing Requirements, Resident Assessment Instructions, Info on Rights for Residents -Hospitals using Medicare & Medicaid are required freedom from physical or chemical restraints that are not clinically necessary
Federal
_______ in nursing is a crime of a SERIOUS nature that carries a penalty of imprisonment or death.
Felony
____________ means agreement to keep promises. -Faithful & true to professional promises & responsibilities -Builds patient trust -Consistency -Dedicated practice of duties in nursing practice practice -Firm adherence to duty -Loyalty Health Ethics Basic Terms
Fidelity
___________ is the process that facilitates the transformation of a person from a layperson to a professional nurse. Nursing Professionalism
Formation
__________ an Ethical Dilemma: •Step 1: Ask if it's an ethical dilemma •Step 2: Gather ALL relevant info •Step 3: Clarify values •Step 4: Verbalize the problem. •Step 5: Identify courses of action •Step 6: Negotiate the outcome. •Step 7: Evaluate the action.
Processing
In demonstrating __________ behaviors, nurses show professionalism by: -Dress Codes -Having a Calm ___________ -Limit/Refrain from Cell Phone Use -Strong Work Ethic Professionalism
Professional, Demeanor
Components of _________: -Rights & Protections to Patients -Privacy & Confidentiality -Right to Medical Records (copying & correcting) & Limits Access to others -Accountability: Penalties for Non-Compliance in protecting private pt. health info •Title I: -Protects health insurance coverage for workers & families that change or lose their jobs -New insurance can't deny u because of pre-existing condition •Title II: -Prevents health care fraud & abuse; (medical liability reform) -Admin. simplification that requires formed national standards for: 1.) Electronic Healthcare Transactions & 2.) National Identifiers for: providers, employers, & health insurance plans. •Title III: -Guidelines for pre-tax medical spending accounts. -Provides changes to health insurance law & deductions for medical insurance. •Title IV: -Guidelines for group health plans -Provides changes tor health coverage •Title V: -Governs company-owned life insurance policies -Makes provisions for treating people w/out U.S. citizenship & repealed financial institution rule to interest allocation rules.
HIPAA
_______ _______ is cognitive & social skills that determine: Motivation & Ability of a Person to: -Access -Understand & -Use Info To Promote & Maintain Health
Health Literacy
______ _______ means everyone regardless of background has intrinsic value & should be respected + treated equally Intrinsic Value: Something that we value for ourselves & not something we do for outside benefit -Part of the character of a person -Intangible & internally rewarding -pleasure, happiness, fulfillment in something -Creativity, truthfulness, temperance, learning new things, mastery of a skill, autonomy, belonging/connectedness, social justice, connection with nature
Human Dignity
_______ of a teaching plan should include: •Maintain attention + participation in Learning •Build on Existing Knowledge •Select Teaching Approach •Incorporate Teaching into Nursing Care
Implementation
________ is maintaining honesty EVEN WHEN circumstances are challenging. -What we do when no one is watching -High moral standards
Integrity
Theory of Multiple __________ takes into consideration knowledge & experience levels in: •Linguistic •Musical/Rhythmic (music) •Logical/Mathematical •Spatial (visual) •Kinesthetic/Movement (body) •Personal •Symbols as intellectual strengths or way of knowing •Emotional Intelligence (EQ)
Intelligences
__________ Torts include: -Assault -Battery -False imprisonment
Intentional
The ________ _______ (TJC's ) Speak Up Tips •Speak up if you have questions or concerns. •Pay attention to the care you get. •Educate yourself about your illness. •Ask a trusted family member or friend to be your advocate. •Know which medicines you take & WHY •Use a carefully __________Health Care Team •Participate IN ALL decisions about YOUR treatment. Role of Nurse in Teaching & Learning
Joint Commission's, evaluate
_______ means being fair. -Care equality. -Making impartial medical decisions regardless of economic status, ethnicity, sexual orientation, etc. -Patient's rights are fair & balanced. -No unfair disadvantages. -Honor Human Rights Health Ethics Basic Terms
Justice
_____________ theories include: •Adult learning theory •Behaviorist theory •Cognitive theory •Constructivist theory •Social learning theory Table 41-1 page 2665
Learning
***__________ issues in nursing includes: -Rights -Responsibilities & -Scope of Nursing Practices-----> ---> As defined by: The State Nurse Practice Acts & Legislated thru Criminal & Civil Laws
Legal
*Legal __________ of Nursing: •Sources of law: 1.) Federal & State Legislation (aka Statutory Law) 2.)Federal Statutory Laws (HIPPA, HITECH, OBRA, ACA/ Pt. Protection & Affordability Act, Emergency Med. Treatm. & Active Labor, Americans w/ Disabilities, Mental Health Parity & Addiction, Pt. Self-Determination Act, Uniform Anatomical Gift) 3.) State Law varies (Nurse Practice Act, Informed Consent & Health Care Acts-vary by state, Legal Informed Consent-minors & adults, Good Samaritan Laws, Public Health Laws, Uniform Determination of Death Act-varies by state) 4.) Criminal Law (felonies or misdemeanors) 5.) Civil Law (Individual Rights, Equality) 6.) Regulatory Law (Administrative Law) 7.) Common Law (Judicial Decisions in Individual Cases) 8.) Case Law (Describes legal case decisions resolved in court) 8.) Constitutional (Right to Refuse Treatment) 9.) Administrative (Regulatory) (further elaborates/defines laws, specific guidelines for things like what 'duty of care entails)
Limits
In Teaching, it is important to choose appropriate Instructional ___________ for your audience. Examples: •Group instruction •One-on-one discussion •Preparatory instruction (prepares for tasks) •Demonstration •Analogy •Role playing •Simulation Implementation
Methods
__________ (lesser crime than a felony). Penalty is usually a fine or imprisonment for less than 1 year.
Misdemeanor
Assess or consider the Patient's Learning __________. ***Info or skills needed to: -Perform Self-Care & -Understand effects of a health problem -Be aware of patient experiences that affect the NEED to LEARN •Info that family caregivers need to support patient needs. How Nurses Identify Educational Needs of Patients
Needs
____________ means avoidance of harm or hurt. -Opposite of intention to mistreat or deprive in an illegal or immoral way -Obligation not to inflict harm on others -Active effort to not cause pain or suffering -Avoiding (or minimizing) Risk -Avoiding Negligence Health Ethics Basic Terms
Non-Maleficence
_________ to Expert Stages: *Stage 1: Novice = Beginner -Little to no experience *Stage 2: Advanced Beginner -Demonstrates basic skills *BUT* -STILL needs guidance & support *Stage 3: Competent -Can plan + make decisions -Performs job responsibilities efficiently *Stage 4: Proficient -Advanced decision-making, knowledge, resourcefulness, flexibility, & problem-solving. *Stage 5: Expert -Role models deep knowledge & skills. -Teaches others -Multitasks effortlessly & fluently
Novice
The __________ Process: •Collect Data: Analyze patient's strengths & weaknesses •Make Nursing Diagnosis •Plan Nursing Goals/Desired Outcomes + Select Appropriate Interventions •Implement Nursing Strategies •Evaluate patient Outcomes (success) based on achievement of goal criteria Comparison of Teaching & Nursing Process
Nursing
SLO means Student Learning ____________.
Objectives
*__________ to consider when teaching: •Illiteracy & other disabilities •Cultural Diversity •Using different teaching tools •Special needs of children & older adults Implementation
Obstacles
***Legal issues in nursing includes: -Rights -Responsibilities & -Scope of Nursing Practices-----> ---> As defined by: The State Nurse ____ ____ & _________thru Criminal & Civil Laws
Practice Acts, Legislated
__________ Intentional Torts include -Invasion of privacy -Defamation of character ~Slander (spoken defamation) ~Libel (written defamation) (Almost but not completely intentional) Civil & Common Law Issues in Nursing Practice
Quasi
_____________ in Nursing means: -An obligation to perform work duties using sound professional judgement -Being reliable, dependable, & persistent in following thru w/commitments -Managers are responsible for resources, employee performance, team building, & conflict resolution. -Managers are also responsible for: time management of team Comparison of Nurse Accountability VS Responsibility
Responsibility
_________ networking presents ethical challenges for nurses
Social
_________ ___________ is awareness of the basic rights to Health & Well-Being of every individual.
Social Justice
______ Statutory Issues in Nursing Practice include: -Licensure -Good Samaritan Laws -Public Health Laws -Uniform Determination of Death Act -Autopsy -Death with Dignity (Physician-Assisted Suicide)
State
The ____________ Process: 1.) Collect data: Analyze patient's learning strengths & weaknesses. 2.) Make Educational Diagnosis -What's going to work for them? 3.) Prepare Teaching Plan -Write learning outcomes -Select content + time frame -Select teaching strategies 4.) Implement Teaching Plan 5.) Evaluate patient learning (success) based on Outcome Comparison of Teaching & Nursing Process
Teaching
_____________ Torts include •Negligence •Malpractice Civil & Common Law Issues in Nursing Practice
Unintentional
_________ behaviors include: •Abuses of power •Bullying •Sexual harassment •Improper use of power
Unprofessional
*Advocacy means Nurses are _________ for: -Advocating for patient safety & ________ (At ALL Times & in ALL Settings) *W/ Advocacy Nurses act to: -Reduce Risk & -Improve Patient outcomes.
accountable, needs
*The Teaching-Learning Process Involves: -Active interaction between teacher & learner. *Participants in the process will __________: -Info -Emotions -Perceptions -Attributes to (connects & credits) the other person
communicate
*Adult Learning Theory helps a nurse plan & provide appropriate _______ teaching for a patient who is recovering. Adults: -Reflect on a situation critically -(May) Need help seeing problem -Can change perspective -Can identify own learning needs -Get dependent w/ new learning situations -Time needed to teach them can vary (situation, developmental stage, willingness, etc.) -Better off when bridging new info w/past experiences -More successful when they view info as important Learning Theories
discharge
*How the nurse identifies _________ needs of the patient. Assess or Consider: •Motivation to learn •Ability to learn •Teaching _________ •Resources for Learning
educational, environment
Teach info that patients & families need to make _______ decisions regarding their care. Role of Nurse in Teaching & Learning
informed
Teaching is the system of activities designed to produce ______________.
learning
Determine what patients _______ to know. Role of Nurse in Teaching & Learning
need
*Code of Nursing Ethics •A set of guiding ________ that all members of a profession accept •Helps professionals resolve issues of practice or ______ •Includes: -Advocacy -Responsibility -Accountability -Confidentiality
principles, behavior
*Ethics is a set of moral ________ or standards that infuences: 1.) ________ & 2.) Relationships *Based on: -Professional nursing beliefs & values.
principles, behavior
Identify when patients are ________ to learn. Role of Nurse in Teaching & Learning
ready
When teaching be aware and _______ to situations of: •Acute illness •Pain •Prognosis •Biorhythms-mental and physical performances have a circadian rhythm. •Emotions •Language •Culture/religion •Physical disability •Mental disability
sensitive