Nursing Studyguide – Flashcards

Quality and Safety Education for Nurses

Health Insurance Portability and Accountability

Situation-Background -Assessment-Recommendation

Population, Intervention, Comparison, Outcome

The IOM (Institute of Medicine) report intents to make recommendations that are action-oriented blueprint for the future of nursing in leading change and advancing health. 2008 the RWJF (Robert Wood Johnson Foundation) and IOM presented a two year initiative to respond to the need to assess and transform the nursing profession. To overcome barriers that prevent nurses from responding effectively to evolving health care systems and changing health care settings.. Key messages Nurses should practice to the full extent of their education and training Nurses should achieve higher levels of education and training through an improved education system that promotes seamless academic progression. Nurses should be full partners, with physicians and other healthcare professionals, in redesigning health care in the United States. Effective workforce planning and policy making require better data collection and an improved information infrastructure.

A national program with the goal of preparing future nurses with the knowledge, skills, and attitudes necessary to continually improve the quality and safety of the health care systems in which they work. pg. 394 QSEN is IOM recommendations through the support of RWJF

-Patient-Centered Care- Recognizes the patient or designee as the source of control and full partner in providing compassionate and coordinated care based on respect for patient's preferences, values, and needs. The patient and family are in a partnered relationship with their healthcare providers and are equipped with relevant information, resources, access, and support to fully engage in and/or direct the healthcare experience as they choose. Transitions among healthcare providers are respectful, coordinated, efficient, and minimize waste and cost. Provides age and culturally-appropriate care to patients. -Teamwork and Collaboration- function effectively within nursing and interprofessional teams, fostering open communication, mutual respect, and shared decision making to achieve quality patient care. -Evidence-Based Practice- integrate best current evidence with clinical expertise and patient/ family preferences and values for delivery of optimal health care. -Quality Improvement- use data to monitor the outcomes of care processes, and se improvement methods to design and test changes to continually improve the quality and safety of health care systems. -Safety- minimizes risk of harm to patients and providers through system effectiveness and individual performance. -Informatics- Use information and technology to communicate, manage knowledge, mitigate error, and support decision making.

Peer-to-peer lateral violence or bullying can be defined as acts between colleagues and is often described as acts perpetrated by someone in a higher level of authority. This behavior may be covert or overt acts of verbal and nonverbal aggression and have been reported to result in psychological distress severe enough to cause some nurses to leave the profession. p239

Leadership within medical team, Coordinates long-term specialized care, Research current treatments and procedures. Liaise(the connection maintained by communications between units of the armed forces or of any other organization in order to ensure concerted action) with insurance companies. Skills: Knowledge in financial and clinical care, management, teaching, negotiating with peers and cross-functional counterparts, attention to detail

The CNL masters degree-prepared generalist who oversees the care coordination of a distinct group of patients in any setting. The CNL actively provides direct patient care in complex situations, evaluates patient outcomes, and has the decision-making authority benefit from the latest innovations in care delivery and is envisioned as a leader in the health care delivery system.

Primary/specialty care provided, Diagnose patients, prescribe medication, perform diagnostic tests, physical examinations, x-rays, counsel patients general process: Assessment of health status Diagnosis Development of treatment plan implementation of the plan follow-up and evaluation of the patient status

CNS's are advanced practice RN's who have had graduate level preparation (MS/Phd) and are clinical experts specializing in specific practice, consultancy, clinical leadership, research, education. Practice autonomously, Integrate knowledge of disease and medical treatments into assessment diagnosis, and treatment of patient's illness. Design, implement, and evaluate both patient-specific and population-based programs of care. Provide leadership in advancing the practice of nursing to achieve quality and cost effective patient outcomes. Provide leadership of multidisciplinary groups in designing and implementing innovative alternative solutions that address system problems and/or patient care issues.

Certified registered nurse anesthetist, master prepared, advanced practice nurse, first healthcare provider dedicated to the specialty of anesthesia. Collaborate with surgeons, dentists and anesthesiologist, administer anesthesia.

Specialized practice of professional nursing, improve the well-being, academic success, and lifelong achievement of students, work in school at every level. Take vitals, provide basic care, oversee medication distribution, develop emergency care plans for students who may need it, administer state mandated hearing and vision tests. First responders, direct health providers, identify threats to health, provide vision and hearing tests, healthy school environment, enable children with chronic health care conditions to attend school, bridge between staff, families, communities, and health care providers, provide case management services.

SBAR: The SBAR can be applied to almost all forms of communication between healthcare professionals and thus provides a standard framework to transfer important information

-Situation-patient information and brief sentence of what is happening now or why your calling -Background-diagnosis, relevant lab and assessment data, chief complaints -Assessment- analysis of the problem, what is of concern -Recommendation- form as a question of what may be a solution or how should problem be solved

NCSBN (2009) describes the nursing process as a scientific problem-solving approach to client care that includes assessment, analysis, planning, implementation and evaluation.

-Assessment 1- gathering information or data about an identified patient/client. Depending on the nurse's focus, the client maybe a person, a family, a group or a community. Information comes from a variety of sources: patient, family, labs, radiology reports.. Patient data is classified in two categories Objective- observable and measurable by nurse and comes from patient record. Subjective- patients perception or understanding of a specific problem/event. -Analysis 2- Nurse classifies or groups assessment data and identifies actual or potential problems.Data is also validated and interpreted during this phase. -Planning 3- Setting realistic and measurable mutual goals. Creating interventions to meet or resolve identified patient needs/problems, and modifying goals as necessary. Goal setting includes the interdisciplinary healthcare team and family. -Implementation 4- This stage includes initiating and carrying out nursing interventions or nursing actions to achieve goal set in the planning phase. Each nursing action should be care goal oriented. Included in this phase are the following: -organizing and managing care -actually performing patient care -overseeing and coordinating the delivery of care -delegating nursing actions to other healthcare workers -teaching and counseling patient, family or caregivers communicating and exchanging patient related information with other health care workers -Evaluation 5- Collect data and document the progress made or not made, in relation to the stated goal. Once data is analyzed, nurse must decide what action to next or modifications to make. (this phase requires documentation and illustrating the patients responses to care provided) Nurse will make one of the following choices: -Resolve the plan because patient has achieved the goal -Continue the plan because the patient is still making satisfactory progress towards the goal, but did not achieve the goal during the original timeframe -Revise the plan because the patient is not making satisfactory progress toward the goal

Improve patient Identification Use at least two patient identifiers Eliminate transfusion errors related to misidentification Improve Communication effectiveness among caregivers Report critical results and diagnostic procedures on a timely basis Improve Medication Safety Label all meds, med containers, and solutions on or off sterile field.. Reduce the likelihood of of patient harm related to use of anticoagulant therapy Maintain and communicate accurate patient med information Reduce the risk of hospital-acquired infections Comply with current World Health Organization (WHO) or CDC hand hygiene guidelines Implement evidence-based practices to prevent healthcare acquired infections caused by multidrug-resistant organisms in acute care settings Implement evidence-based practice to prevent central line associated bloodstream infections Implement evidence-based practices to prevent surgical site infections Implement evidence-based practices to prevent catheter associated UTI Reduce Falls Reduce fall risks Reduce pressure ulcers Assess and reassess periodically each patient's risk for developing pressure ulcers, take action to address any identified risks Organization Identifies safety risk inherent in its patient population Identify patients at risk for suicide Identify risks associated with home oxygen therapy, such as home fire Universal protocol for wrong site, procedure, or surgery Conduct pre-procedure verification process Mark procedure site Perform time-out procedurey

Guideline aimed towards quality improvement and patient safety Safety- Preventing injuries to patients from the care that is intended to help them Timely- Reducing waits and harmful delays for both those who receive care and who give care Effective- Providing service based on scientific knowledge to all who could benefit, and refrain from those not likely to benefit. Efficient- Preventing waste: Equipment, supplies, ideas and energy Equitable- Providing care that does not vary in quality because of personal characteristics, such as gender, ethnicity, geographic location, and socioeconomic status. Patient centered- Providing care that is respectful of and responsive to individual patient preferences, needs, and values and ensuring that patient values guide all clinical decisions.

PICO model is a helpful tool used to organize and focus your question. Patient population (e.g., very low birth weight infant) Intervention of interest (e.g., minimal enteral feedings) Comparison of interest (e.g., delayed enteral feedings) Outcome of interest (e.g., incidence of necrotizing enterocolitis, growth)

Bioethics - The study of ethical problems resulting from scientific advances (Cherry, Ch.9). Interdisciplinary field within health care organization that has developed only in the past four decades. Whereas ethics has been discussed since there was written language, bioethics has developed with the age of modern medicine, specifically with the development of hemodialysis and organ transplantation. Bioethics is a response to these and other contemporary advances and challenges in health care.

Autonomy - right to self-determination; the principle of respect for a person, is sometimes labeled as the primary moral principle. People are free to form their own judgments and whatever actions they choose. They are self-determining agents, entitled to determine their own destiny. Beneficence - to promote goodness, kindness, and charity; to provide benefits to others by promoting their good.. Nonmaleficence - duty not to inflict harm; to abstain from injuring others and to help others further their own well-being by removing harm and eliminating threats. Veracity - ethical duty to tell the truth.