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The AMA (our professional organization): Nursing is the protection, promotion, and optimization of health care abilities, prevention of illness and injury, aleviation of suffering through the diagnosis and treatment of human response, and advocacy in the care of individuals, families, communities, and populations.

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The "treatment of human response" is what nurses adresses, no other discipline has this responsibility.

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Nurses play various roles in all settings to include: - Caregiver: Primary role of the nurse - Communicator: Interpersonal and theraputic communication skills - Teacher: Teaching plans for patients and families - Counselor: Facilitate decision making by patients

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- Leader: Assertive within groups - Researcher: Improve knowledge and patient care - Advocate: Protection of human rights and their ability to make decisions about their care - Collaborator: Facilitates all functions of the health care team

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What is the primary role of the states Board of Nursing?

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To protect the patient - It defines: -- Scope of practice: Who can do what (CNA, LPN, RN) -- Rules and Regulations: Regulates practice such as overtime laws -- Criteria for Education: Competency regulation -- Defines terms: Delegation, functions

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The ANA defines the nursing scope and standards of practice, the state boards of nursing makes them laws for that state.

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...

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Current concerns in nursing: - Nursing shortage - EBP: Needed to improve care - Community-based nursing: Increased due to managed care, minimize cost - Decreased length of hospital stay: More complex care at home, teaching family more advanced care

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- Aging process - Increasse in chronic care conditions: More people living longer with chronic conditions - Independent nursing practice: Advanced practice nurses - Culturally competent care: Alternative care to suit different cultures

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This is the knowledge base for the nursing care that is given?

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Science of Nursing

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This is the skilled application of nursing knowledge to help others reach maximum health and quality of life?

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Art of Nursing

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What are the four broad aims (primary objectives) of nursing practice?

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1. To promote health 2. To prevent illness 3. To restore health 4. To facilitate coping with disability or death

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This person defined nursing as an art and a science, differentiated nursing from medicine, created freestanding education, established nursing education, maintained and initiated health records, and is considered the founder of modern nursing?

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Florence Nightingale

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This person volunteered to care for wounded union soldiers, organised hospitals and nurses, and established the Red Cross in 1882?

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Clara Barton

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This person was the superintendent of the Female Nurses of the Army during the civil war and was a pioneering crusder for the reform of the treatment of the mentally ill?

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Dorthea Dix

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This person established a neighborhood nursing service for the sick and poor of NYC and was the founder of public health nursing?

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Lilian Wald

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This person was the first African American nurse?

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Mary Elizabeth Mahoney

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This is defined as the ability of patients to obtain, process, and understand the basic information needed to make appropriate decisions about health?

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Health Literacy

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This organization's standards of nursing practice protect and allow nurses to carry out professional roles?

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ANA (American Nurses Association) - Addresses ethics, public policy, and the economic and general welfare of nurses.

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This organization fosters the development and improvement of all nursing services and nursing education, open to all nurses and non-nurses, conducts pre-nursing testing, and is the primary source for educational research data?

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NLN (National League of Nursing)

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This organization is a national voice for BSN and higher degree nurse education programs?

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AACN (American Association of Colleges in Nursing)

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This national organization is for students enrolled in nursing education programs?

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NSNA (National Student Nurses' Association)

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These define the actions, procedures, etc. that are permitted by law for a specific profession. It is restricted to what the law permits based on specific experience and educational qualifications?

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Scope of practice - Appropriate practice (training) - Competence (What you are doing and why) - Delegation (Who you can or cannot delegate to)

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These are laws established in each state to protect the public by regulating the practice of nursing including education and licensure?

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Nurse Practice Acts (Each nurse needs to practice within defined practice limits or be vulnerable to cahrges of violating this act)

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This is used by the nurse to identify the patient's healthcare needs and strengths, to establish and carry out a plan of care to meet those needs, and to evaluate the effectiveness of the plan to meet established outcomes?

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Nursing Process

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Cultural norms of the healthcare system: - Beliefs: Standardized definitions of health and illness, Omnipotence of technology. - Practices: Maintenance of health and prevention of illness, Annual physical exams and diagnostic prcedures.

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- Habits: Documentation, Frequent use of Jargon, Use of systematic approach to problem solving. - Likes: Promptness, Neatness and organization, Compliance - Dislikes: Tardiness, Disorderliness - Customs: Professional deference and adherence to pecking order, Use of certain procedures attengin birth and death

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Culturally competent care means providing care that is planned and implemented in a way that is sensitive to the needs of individiuals, families, and goups from diverse populations within society.

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- Develop cultural self-awareness - Develop cultural knowledge - Accomidate cultural practices in healthcare - Respect culturally based family roles - Avoid mandating change - Seek assistance *The healthcare system is a culture with customs, rules, and language of its own.

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This is defined as a shared system of beliefs, values, and behavioral expectations that provides social structure for daily living?

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Culture

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This is a sense of identification with a collective cultural group, largely based on the groups common heritage?

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Ethnicity

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This is based on specific physical characteristics such as skin pigmentation, body stature, facial features, and hair texture?

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Race - Three major races: Caucasion, Mongoloid, Negroid

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This is the belief that everyone should conform to your own belief system?

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Cultural Imposition

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This occurs when one ignores differences in culture and proceeds as though they do not exist?

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Cultural Blindness

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This occurs when people become aware of cultural differences, feel threatened, and respond by ridiculing the beliefs and traditions of other to make themselves feel more secure about their own values?

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Cultural Conflict

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This belief, closely related to cultural imposition, is where one's own ideas, beliefs, and practices are the best, are superior, or are most preferred to those of others?

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Ethnocentricity

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This is care that addresses the many dimensions that comprise the whole individual? (The nurse must understand and respect each person's own definition of health and responses to illness and should be familiar with models of health and illness)

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Holistic Care

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This is a state of complete physical, mental, and social well-being, not merely the absence of disease or infirmity (This is individually defined)?

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Health

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This is a term often interchangeably with health, is an "active" state of being healthy by living a lifestyle that promotes good physical, mental, and emotional health?

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Wellness

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This is a unique response of the person to a disease, level of function has changed, and can be accute or chronic?

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Illness

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This is a medical term, menaing that there is a pathologic change in the structure or function of the body or mind?

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Disease

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What are the four stages of illness?

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Stage 1: Experienceing symptoms Stage 2: Assuming the sick role Stage 3: Assuming a dependent role Stage 4: Achieving recovery and rehabilitation

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Current trends that result in an increase in chronic illnesses include: (1) growing numbers of older adults (2) lifestyle choices (3) environmental factors (4) the AIDS epidemic

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...

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The factors influencing a person's health-illness status, behavior, health beliefs, and health practices relate to the person's human dimensions.

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The human dimensions that affect health-illness are: - Physical (genetic inheritance, race, gender, age, and dev. level) - Emotional (stress, happiness, sadness, relaxation, poor self-esteem) - Intelectual (cognitive abilities, educational background, and past experiences) - Environmental (housing, sanitation, climate, and air/water/food polution) - Sociocultural (family structure, economic level, lifestyle, culture) - Spiritual (beliefs, values)

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The 6 major areas of types of risk factors for illness and injury are: 1. Age 2. Genetic factors 3. Physiological factors 4. Health habits 5. Lifestyle 6. Environmental

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...

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This is the behavior of an individual that is motivated by a personal desire to increase well-being and health potential?

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Health Promotion

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Primary health promotion and illness prevention is directed toward promoing health and preventing the development of disease processes or injury.

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Nursing role: - Focus on individuals or groups - Immunization clinics - Family planning services - Providing poison control information - Providing accident prevention information - Teaching healthy diet, exercise, weight loss - Farm safety

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Secondary health promotion and illness prevention focuses on screening for early detection of disease with prompt diagnosis and treatment of those found.

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Nursing role: - Assessing children for noramal growth and dev. - Encorage regular dental, health, vision exams - GYN exams - Mammograms - Medication administration - Wound care

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Tertiary health promotion and disease prevention begins after an illness is diagnosed and treated to reduce disability and to help rehabilitate patients to a maximum level of funtioning.

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Nursing role: - Diabetes complication/recognition teaching - PT/OT for spinal injury patients - Referral to support group followng mastectomy - Monitor responses to therapy and referral to other agencies

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Models of why and how individuals carry out behaviors to promote health and prevent illness are usefull to nurses to understand health related behaviors, what are the 4 models?

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1. Health belief model 2. Health promotion model 3. Health-illness continuum 4. Agent-host-environment model

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This model of health promotion and illness prevention is concerned with what people percieive, or believe, to be true about themselves in relation to their health? (1) Percieved suceptibility to a disease, (2) perceived seriousness of a disease, (3) perceived benefits of action

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Health Belief Model

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This model of health promotion and illness prevention was developed to illustrate how people interact with their environment as the pursue health? (Behavior specific knowledge, beliefs, and relationships are considered to be mahor motivators for engaging in health promoting behaviors)

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Health Promotion Model

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This model of health promotion and illness prevention views health as a constantly changing state, with high level wellness and death being on opposite ends of a graduated scale?

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Health-Illness Continuum

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This model of health promotion and illness prevention is useful for examining the causes of disease in an individual?

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Agent-Host-Environmental Model

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Maslow's hierarchy of needs has 5 levels, what are those levels?

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1. Physiological 2. Safety and Security 3. Love and Belonging 4. Self-Esteem 5. Self-Actualization

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Maslow's hierarchy of needs and examples: 1. Physiological: Oxygen, air, water, food, elimination, sexuality, rest 2. Safety and Security: Both physical and emotional security 3. Love and Belonging: (higher level need) Understanding and acceptance, belonging, giving and recieving love

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4. Self-Esteem: Feel good about himself, pride, sense of accomplishment, respect and appreciation fo others 5. Self-Actualization: Individuals reaching their full potential through development of their unique capabilities. (In order for nurses to help patients meet self-actualization needs they should focus on the person's strengths and possibilities rather than on problems)

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Nursing theories provide a means of testing knowledge through research and for expanding nursing's knowledge base to meet the healthcare needs of patients in an ever-changing society.

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The theoretical framework can provide a guide to improving nursing care by testing theories, changing practices, or provide a base for evaluation.

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The five major areas of family function that help it's members meet basic needs, they include: physical, economic, reproductive, affective and coping, and socialization.

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- Physical: Family provides safe, comfortable environment to grow and dev. - Economic: Family provides financial aid to family members and meets monitary needs. - Reproductive: Raising the children. - Affective and coping: Family providing emotional support. - Socialization: Family teaches, transmits beliefs, values, attitudes, etc...

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Family Risk Factors: - Family patterns of behavior, the environment in which the family lives, and genetic factors can all place family members at risk for health problems.

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Social Support System: - This is made up of all the people who help meet financial, personal, physical, and emotional needs of the individual.

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Nursing in the Community: - In contrast to communtiy-health nursing, which focuses on populations within a community, community-based nursing is centered on individual and family healthcare needs.

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The nurse practicing community-based nursing provide interventions to manage acute or chronic health problems, promote health, and facilitate self-care.

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Nursing knowledge comes from a variety of sources and may be traditional, authoritative, or scientific.

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Both traditional and authoritative knowledge are practical to impplement but are often based on subjective data limiting their usefulness, for this reason nurses increasingly focus on scientific knowledge to provide care, commonly called evidence-based practice.

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This source of nursing knowledge is that part of nursing practice passed down from generation to generation?

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Traditional Knowledge "We've always done it this way"

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This source of nursing knowledge is that knowledge arrived at through the scientific method (implying through research)?

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Scientific Knowlegde

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This source of nursing knowledge comes from an expert and is accepted as truth based on the person's perceived expertise?

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Authoritative Knowledge

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This type of knowledge is observing, identifying, describing, investigating, and explaining events and occurences that are perceived in the world?

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Science knowledge

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This type of knowledge is the study of wisdom, fundamental knowledge, and the processes used to develop and construct one's perceptions of life?

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Philosophy

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This type of knowledge is a series of actions, changes, or functions inteded to bring about a desired result. One takes systematic and continuous steps to meet a goal and uses assements and feedback to direct actions?

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Process

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These are a group of concepts that describe a pattern of reality?

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Theory

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These, like ideas, are abstract impressions organized into symbols of reality and describe objects, properties, and events and relationships among them?

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Concepts

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Theories can be tested, changed, or used to guide research or to provide a base for evaluation, they are derived through two principle methods: - Deductive reasoning - Inductive reasoning

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- Deductive reasoning: One examines a general idea and then considers specific actions or ideas. - Inductive reasoning: The reverse process is used, one builds from specific ideas or actions to conclusions about general ideas.

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This is developed to describe nursing, it differentiates nursing from other disciplines and activities in that it serves the purposes of describing, explaining, predicting, and controlling desited outcomes of nursing care practices?

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Nursing Theory

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Nursing theories are often based on, and influenced by, other boradly applicable processes and theories. Three theories in particular are: - General Systems Theory - Adaptation Theory - Developmental Theory

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...

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This theory describes how to break whole things into parts and then learn how the parts work together in "systems". It emphasizes relationships between the whole and the parts and describes how parts function and behave?

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General Systems Theory

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This theory is defined as the adjustment of living matter to other living things and to environmental conditions?

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Adaptation Theory

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This theory outlines the process of growth and development of humans as orderly and predictable, begining with coneption and ending with death?

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Developmental Theory

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Nursing theory provides rational and knowledgeable reasons for nursing iterventions, based on descriptions of what nursing is and what nurses do.

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Nursing theories may be descriptive or prescriptive. - Descriptive theories discribe a phenomenon, and event, a situation, or a relationship. - Prescriptive theories address nursing interventions and the consequences of those interventions; they are designed to control, promote, and change clinical nursing practice.

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Four concepts common in nursing theory that influence and determine nursing practice are: 1. The person (patient) 2. The environment 3. Health 4. Nursing

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Theoretical concepts and theories guide all phases of the nursing process, including planning, implementing, and evaluating nursing care, while also describing and explaining desired responses to and outcomes of care.

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Nursing research, broadly defined, encompasses both research to improve the care of people in the clinical setting and also the broader study of people and the nursing profession, including studies of education, policy development, ethics, and nursing history.

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Goals of Nursing Research: - Improve care in the clinical setting - Study people and the nursing process - Develop greater autonomy - Provide evidence-based nursing practice

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This type of research is somtimes called pure or laboratory research, it is designed to generate and refine theory, and the findings are often not directly useful in practice?

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Basic Research

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This type of research is also called practical research and is designed to directly influence or improve clinical practice?

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Applied Research

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This type of research is a method of research conducted to gain insight by discovering meanings, it is based on the belief that reality is based on perceptions, which differ fo each person and change over time? (The researcher primarily researches words rather than numbers)

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Qualitative Research

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This type of practice in nursing a problem-solving approach to making clinical decisions, using the best evidence available?

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Evidence-based practice (EBP blends both the science and the art of nursing so that the best patient outcomes are achieved)

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The impetus (rationale) for EBP (Evidence-based practice) is based in the Institute of Medicine report that challanged healthcare professionals to provide care based on scientific evidence.

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5 steps to implementing EBP: 1. Ask question about a clinical area of interest or intervention. 2. Collect most relevant and est evidence. 3. Criticlly appraise the evidence. 4. Integrate the evidence with clinical experise, patient preferences, and values in making a decision to change. 5. Evaluate the practice decision or change.

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These summarize findings from multiple studies of a specific clinical practice question or topic, and recommend practice changes and future directions from research?

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Systematic Reviews

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Evidence-based practice guidelines synthesize information from multiple studies and recommend best practices to treat patients with a disease or disability.

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Meta-analysis uses statistical analysis of the effect of a specific intervention across multiple studies, providing stronger evidence than results from a single study.

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This is a belief about the worth of something, about what matters, that acts as a stadard to guide one's behavior?

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Values

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Common modes of value transmission include: 1. Modeling 2. Moralizing 3. Laissez-faire 4. Rewarding and punishing 5. Responsible choice

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...

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This form of value transmission is where children learn what is of high or low value by observing parents, peers, and significant others?

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Modeling

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This form of value transmission is where children are taught a complete value system by parents or an institution that allows them little opportunity to weight different values?

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Moralizing

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This form of value transmission leaves children to explore values on their own and to develop a personal value system?

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Laissez-faire

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This form of value transmission is where children are rewarded for demonstrating values held by parents and punished for demonstrating unacceptable values?

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Rewarding and punishing

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This form of value transmission is where we encorage children to explore competing values and to weigh their consequences.

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Responsible-choice

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This is a concern for the welfare and well-being of others?

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Altruism

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This is the right to self-determination, professional practice reflects this when the nurse respects patients' rights to make decisions about their healthcare?

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Autonomy

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This is the respect for the inherent worth and uniqueness of individuals and populations?

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Human dignity

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This is upholding moral, legal, and humanistic principles, this value is reflected in professional practice when the nurse works to assure equal treatment under the law and equal access to quality healthcare?

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Social justice

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This is the process by which people come to understand their own values and value system?

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Values clarification

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Values clarification: - Choosing: One chooses freely from alternatives after careful consideration of the consequences of each alternative. - Prizing: Something one values involves pride, happiness, and public affirmation. - Acting: The person who values something "acts" by combining choice into one's behavior with consistency and regularity on the value.

answer

...

question

This is a systematic inquiry into pinciples of right and wrong conduct, or virtue and vice, and of good and evil as they relate to conduct and human flourishing?

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Ethics

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There are many types of ethics, those of particular concern to the nurse are: - Bioethics - Nursing ethics - Clinical ethics

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Ethical theories or frameworks are systems of thought that attempt to explain how we ought to live and why.

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This type of ethics of concern to nurses encompasses a number of fields and disciplines grouped broadly under the rubric "life sciences"?

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Bioethics (Involves responsible research conduct, genetic enhancement, environmental ethics, and sustainable healthcare)

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This type of ethics of concern to nurses is that branch of bioethics literally concerned with ethical problems at the bedside?

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Clinical ethics

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This type of ethics of concern to nurses is a subset of bioethics and is the formal study of ethical issues that arise int he practice of nursing and of the analysis used by nurses to make ethical judgments?

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Nursing ethics

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Action-guiding ethical theories fall into one of two main catagories: 1. Utilitarian 2. Deontologic

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...

question

This form of action-guiding ethical theory is the rightness or wrongness of an action that depends on the consequences of the action?

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Utilitarian theory

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This form of action-guiding ethical theory is where an action is right or wrong independent of its consequences?

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Deontologic theory

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Nurse ethics frequently use two popular theoretical and practical approaches to "doing ethics": - Principle based approach - Care-based approach

answer

...

question

This nursing approach to doing ethics combines elements of both utilitarian and deontologic theories and offers specific action guides for practice?

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Principle-based approach

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In this nursing approach to doing ethics the nurse-patient relationship is central, it directs attention to the specific situations of individual patients viewed within the context of their life narrative?

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Care-based approach

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This is where the nurse avoids causing harm to the patient?

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Nonmaleficence

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This is where the nurse gives each individual his or her own due, act fairly?

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Justice

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This is where the nurse acts to benefit the patient, and balance benefits against risks and harms?

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Beneficence

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This type of ethical approach is popular among nurses, it aims to critique existing patterns of oppression and domination in society, especially as these affect women and the poor?

answer

Feminist ethics (Nurses that work within feminist ethics promote social policy)

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Nursing Code of Ethics (Guides Practice): - Maintain confidentiality - Act as patient advocates - Provide nonjudgemental care that is sensitive to diversity - Deliver care protecting patient autonomy, dignity, and rights - Seek resources to formulate ethical decisions.

answer

...

question

This is the ability to behave in an ethical way and to do the ethically right thing because it is the right thing to do, it MUST be cultivated and is not necessarily inherant to all people?

answer

Ethical agency

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These are human excellencies, cultivated dispositions of character, and conduct that motivate and enable us to be good human beings?

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Values

question

This is a set of principles that reflect the primary goals, values, and obligations of the profession?

answer

Code of ethics

question

Two of the chief reasons nurses cite for the declining quality of nursing care at their facilities are: - Inadequate staffing - Decreased nurse satisfaction

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To aid in improving workplaces and ensuring nurses' ability to provide safe, quality patient care a Nurses Bill of Rights was enacted. It is intended to empower nurses by making clear what is absolutely nonnegotiable in the workplace.

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Two types of ethical problems commonly faced by nurses are: - Ethical dilemas - Ethical distress

answer

...

question

With this ethical nursing problem, two (or more) clear moral principles apply but support mutually inconsistent courses of action?

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Ethical dilemma

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With this ethical nursing problem, the nurse knows the right thing to do but either personal or institutional factors make it difficult to follow the correct course of action?

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Ethical distress

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The nursing process can be used to make ethical decisions for the patient.

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1. Asses the Situation (Gather data) 2. Diagnose the Ethical problem (Identify) 3. Plan 4. Implement your Decision 5. Evaluate your Decision

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This is the term used to describe a nurse that acts on behalf of a patient without their consent to secure good or prevent harm?

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Paternalism

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Sources of laws: - Constitutional: Fed and state - Statutory: Must keep in with state and fed law (Nurse Practice Act)

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- Administrative law: Agencies that enforce the law (Boards of Nursing at state level). - Common law: Accumulated judiciary decision, court-made law, presidence (Malpractice).

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Nursing standards are voluntary, they are developed and implemented by the nursing profession itself, are not mandatory but are used as guidelines for peer review.

answer

...

question

This refers to the ways in whch professional competence is ensured and maintained?

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Credentialling (Three ways this is done, accredidation, licensure, certification)

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This is the process by which an educational program is evaluated and reognized as having met certain standards?

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Accreditation

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This is the process by which a state determines that a candiddate meets certain minimum requirements to practice in the profession?

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Licensure

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This is the process by which a person who has met certain criteria established by a nongovernmental association is granted reognition in a specified area?

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Certification

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This is defined as performing an act that a reasonably prudent person under similar circumstances would not do or, conversely, failing to perform an act that a resonably prudent person under similar circumstances would do?

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Negligence (Malpractice is negligence by a professional person)

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This is an oral defamation of character?

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Slander (Libel is when this is written)

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Four Elements of Liability: - Duty: Doing your job properly - Breach of duty: Failure to do your job properly - Causation: Something you did or did not do caused the injury. - Damages: Results of negligent actions

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Common sources of negligence: - Not following standards fo care - Improper equipment use - Inadequate cimmunication - Documentation - Act as a patient advocate

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Legal sfaegaurds for nurses: - Informed consent - Contracts - Collective bargaining - Competent practice - Patient education - Documentation

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- Adequate staffing - Professional liability insurance - Risk management programs - Incident reports, JCAHO sentinal events - Patient Bill of Rights - Good Sam laws

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Obtaining an informed consent is the responsibility of the person performing the procedure, the nurses role is to confirm the signed consent form is present in th chart and to answer any questions the patient may have.

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The nurse can sign the form as a whitness to seeing the patient sign the form, not having obtained the consent itself. Elements of the consent include: - Disclosure - Comprehension - Competence - Voluntariness

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Methods of Healthcare Delivery: - Managed Care Systems - Case Management - Primary Care

answer

...

question

In this type fo care the individual is carefully panned and monitored by the primary care provider, sometimes referred to as the case manager from begining to end. It limits the choice of care providers and may require approval for specialty care?

answer

Managed Care

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This is a method used to coordinate a pts care to achieve wellness and optimum function, it is an interdisciplinary process of assessing, planning, facilitating, and advocating for option to meet the care needs of an individual?

answer

Case Management - The nurse monitors care and ensures appropriate referals are made, that the plan of care is evidence-base and follows standards.

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This is defined as essential healthcare based on practical, scientificall sound, and socially acceptable methods and technology, made universally accessible to individuals and families in the community through their full participation and at a cost the community can afford?

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Primary Care - Emphasizes affordability and universal access, health of the whole population, and consumer involvement.

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The Public Health Service is a federal health agency under the direction of the US Department of Health and Human Services (CDC, National Institutes of Health).

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The primary goal of each member of the healthcare team, is to promote and restore health.

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Healthcare Settings and Services: - Hospitals: Public/Private, Profit/Non-profit - Primary Care Centers: Physicians or APRN's provide care, treatment, diagnosis, minor surgeries, OB, and counseling in offices or clinics. - Ambulatory Care Centers and Clinics

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Healthcare Settings and Services: - Home Healthcare - Long-Term Care - Specialized Care Centers and Settings

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Specialized Care Centers and Settings: - Daycare Centers - Mental Health Centers - Rural Health Centers - Schools - Industry - Homeless Shelters - Rehabilitation Centers

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Healthcare Services for Caregivers and End-of-Life Care: - Respite Care: Gives caregivers time away - Hospice Services - Palliative Care: Focused on the relief of physical, mental, and spriritual distress

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Health Agencies: - Voluntary Agencies: Meals on Wheels, AHA, ALA - Parish Nursing: Emphasizes holistic care, health promotion, disease-prevention within a faith community. - Government Agencies: Military, VA, Public Health Services / Agencies

answer

Interdisciplinary Healthcare Team: - Physician - PA - PT, RT, OT - Speech Therapy - Dietitian - Pharmacist - Social Worker

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Federally Funded Healthcare programs: - Medicare: Pays hosp. fixed amount for treatment according to diagnosis (Pts pay both deductable and monthly premium), Part A reimburses inpatient costs, Part B covers out-patient costs and is voluntary. - Medicaid: Federally funded public assistance for any age & low income.

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Group Healthcare Plans: - HMO's: Pre-paid group-managed care from affiliated providers (Copay or small fee). - PPO's: Group of providers that have lower fees for prompt payment and guaranteed volume of pateints/services (Third party payer). - Private Insurance

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The National Academy of Sciences propsed 5 core competencies for healthcare professionals: 1. Provide pt centered care 2. Work in interdisciplinary teams 3. Used EBP 4. Apply QI 5. Use informatics

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Goals of healthcare reform: - Cost containment - Improved access - Increased quality services

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To provide continutiy of care the nurses must consider teaching and referrals in the care of any person amitted to any type of healthcare setting and should involve the family in a mutual planning process.

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This planning also requires the involvement of other members of the healthcare team.

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Essential components of discharge planning include: - Assessing the strengths and limitations of the patient, family, support person, and environment. - Implementing and coordinating the plan of care. - Considering individual, family, and community resources. - Evaluating the effectiveness of care.

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Guidelines for Discharge Planning: - Assessing and identifying healthcare needs. - Setting goals with the patient. - Teaching - Meeting eligability requirements for home healthcare

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In contrast to "community health" and public health nursing (which are population based and focus on the health of the community), "community-based" care is centered on individuals and their families healthcare needs.

answer

It emphasizes the provision of comprehensive, coordinated, and continuous services for pts with accute or chronic health problems.

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