question

During the outcome identification and planning steps of the nursing process, the nurse works in partnership with the patient and family to do 4 things. List them

answer

-establish priorities -identify and write expected patient outcomes -select evidence-based nursing interventions -communicate the plan of nursing care

question

Patient outcome

answer

expected conclusion to a patient health problem

question

Difference between goal and outcome

answer

outcome is used to describe goals achieved

question

The words 'goal', 'objective', and 'outcome' are often used....

answer

interchangeably

question

What is the primary purpose of the outcome identification and planning step of the nursing process?

answer

to design a plan of care for and with the patient that, once implemented, results in the prevention, reduction, or resolution of patient health problems and the attainment of the patient's health expectations, as identified in the pt. outcomes.

question

List the nursing's broad aims

answer

promote wellness prevent disease and illness promote recovery facilitate coping with altered functioning

question

This is a common problem in all healthcare settings

answer

failure to update the plan of care

question

What is the chief purpose of initial planning?

answer

it addresses each problem listed in the prioritized nursing diagnoses and identifies appropriate pt. goals and the related nursing care

question

What is the chief purpose of ongoing planning?

answer

to keep the plan up to date to facilitate the resolution of health problems, manage risk factors, and promote function.

question

Discharge planning is best carried out by..

answer

the nurse who worked most closely with the patient + a social worker

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Maslow's Hierarchy of Human Needs

answer

1. physiologic needs 2. safety needs 3. love and belonging needs 4. self-esteem needs 5. self-actualization needs

question

Outcomes are derived from the _________ of the nursing diagnosis

answer

problem statement

question

This is the first comprehensive standardized language used to describe the patient outcomes that are responsive to nursing intervention

answer

The nursing outcomes classification

question

Cognitive outcomes

answer

describe increases in pt. knowledge or intellectual behavior

question

Psychomotor outcomes

answer

describes the pt's achievement of new skills

question

Affective outcomes

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Describes changes in pt's values, beliefs, and attitudes

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This directs the nurse to derive culturally appropriate expected outcomes from the diagnoses

answer

The ANA standards of practice act

question

To be measurable, outcomes should have what 5 things?

answer

-subject -verb -conditions -performance criteria -target timing

question

Verbs to be avoided when writing goals

answer

know, understand, learn, become aware

question

Verbs that helpful when writing outcomes are ______ and _____.

answer

observable and measurable

question

Evaluative statements include...

answer

a statement about achievement of the desired outcome and the actual patient behavior as evidence supporting the statement

question

Nursing intervention

answer

any treatment based on clinical judgment and knowledge that a nurse performs to enhance pt. outcomes

question

Nursing interventions are...

answer

nurse-initiated, physician initiated, and collaborative initiated

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Nurse initiated intervention

answer

an autonomous action based on a scientific rationale that a nurse executes to benefit the pt in a predictable way related to the nursing diagnosis and projected outcomes

question

Nurse initiated interventions do not require..

answer

a physician's order

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This suggests the nursing interventions

answer

etiology

question

Comprehensive nursing interventions specify....

answer

-what observations need to be made and how often -what nursing interventions need to be done -what teaching, counseling, and advocacy needs patients and families have

question

Standard of care

answer

a description of an acceptable level of patient care or professional practice

question

Algorithm

answer

a set of steps that approximates the decision process of an expert clinician and is used to make decisions

question

Who writes the plan of nursing care? When is it done?

answer

the nurse who best knows the patient and is recorded on the day the patient presents for treatment and care according to agency policy

question

Clinical pathways

answer

tools used to communicate the standardized, interdisciplinary plan of care for patients

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What is the purpose of implementing?

answer

to assist the patient in achieving valued health outcomes: promote health, prevent disease and illness, restore health, and facilitate coping with altered functioning

question

During this step, the nurse continues to collect data and to modify the plan of care as needed

answer

implementing

question

Whereas other healthcare pros focus on selected aspects of the patient's treatment regimen, nurses are concerned with...

answer

how the patient is responding to the plan of care in general

question

These people are specialists in the role of care coordinator

answer

nursing care managers

question

Nursing intervention

answer

any treatment based upon clinical judgment and knowledge that a nurse performs to enhance patient/client outcomes

question

Protocols

answer

written plans that detail the nursing activities to be expected in specific situations

question

This is the nurse's most important task and should receive top priority

answer

the plan of care

question

Nurses modify their nursing actions according to what 3 things?

answer

1. changing ability and willingness to participate in the plan of care 2. previous responses to nursing interventions and progress toward goal/outcome achievement 3. developmental stage and psychosocial bg

question

Nurse variables that influence the implementation of the plan of care

answer

1. levels of expertise 2. creativity 3. willingness to provide care 4. available time

question

Unlicensed assistive personnel (UAPs) are also known by what name?

answer

nurse-extenders

question

What is the purpose of evaluation?

answer

to allow the patient's achievement of expected outcomes to direct future nurse-patient interactions

question

This is the most important act of evaluation performed by nurses

answer

evaluating outcome achievement with the patient

question

5 classic elements of evaluation of care

answer

1. identifying evaluative criteria and standards 2. collecting data to determine whether these criteria and standards are met 3. interpreting and summarizing findings 4. documenting your judgment 5. terminating, continuing, or modifying the plan

question

What is evaluative criteria? Evaluative criteria is also the ____ of the evaluation.

answer

the patient outcomes developed during the planning step core

question

What are the functions of evaluation?

answer

Determining whether these outcomes have been or are being met and then identifying the appropriate nursing response are the functions of evaluation.

question

Criteria

answer

measurable qualities, attributes, or characteristics that specify skills, knowledge, or health states. They describe acceptable levels of performance by stating the expected behaviors of the nurse or the patient

question

Define Standards. How are they established?

answer

the levels of performance accepted and expected by the nursing staff or other health-team members. They are established by authority, custom, or consent

question

Whereas the nurse collects data in the nursing assessment to identify patient health problems, the data collected in the evaluation step are used......

answer

to determine whether the identified health problems have been or are being resolved through outcome achievement.

question

This can determine whether affective outcomes have been achieved.

answer

Observation of patient behavior and conversation

question

The most common mistake nurses make when evaluating in acute care settings is...

answer

waiting until the day the patient is to be discharged before evaluating outcome achievement

question

After the data have been collected and interpreted to determine patient outcome achievement, the nurse makes and documents a judgment summarizing the findings. What is this called?

answer

evaluative statement

question

What does the evaluative statement entail?

answer

includes a decision about how well the outcome was met, along with patient data or behaviors that support this decision

question

The following four steps are crucial in improving performance

answer

1. Discover a problem. 2. Plan a strategy using indicators. 3. Implement a change. 4. Assess the change; if the outcome is not met, plan a new strategy.

question

quality-assurance programs

answer

Specially designed programs that promote excellence in nursing

question

The ANA model directs attention to three essential components of quality care. List them.

answer

structure, process, and outcome

question

Quality improvement

answer

the commitment and approach used to continuously improve every process in every part of an organization, with the intent of meeting and exceeding customer expectations and outcomes

question

Quality improvement vs. quality assurance

answer

unlike quality assurance, quality improvement is internally driven, focuses on patient care rather than organizational structure, focuses on processes rather than individuals, and has no end points.

question

Concurrent evaluation

answer

direct observation of nursing care, patient interviews, and chart review to determine whether the specified evaluative criteria are met.

question

Retrospective evaluation

answer

postdischarge questionnaires, patient interviews (by telephone or face to face), or chart review (nursing audit) to collect data

question

Factors to consider before delegating any nursing intervention

answer

1. pt's condition 2. complexity of activity 3. potential for harm 4. degree of problem solving and innovation to carry out the task 5. level of intervention required with the patient 6. capabilities of the person being delegated to 7. availability of the pro staff to accomplish work load

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