CSUN Nursing 318 quiz 1 – Flashcards
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PSROs (Professional standards review organizations)
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- reviews the quality, quantity and cost of hospital care provided through Medicare and Medicaid
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URs (Utilization review committees
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- review admissions, diagnostic, testing and treatments provided by physicians who cared for patients receiving medicare
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Patient Protection and Affordable Care Act
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- provides access to health care for all - reduces costs - improves quality
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Health care settings and services
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1. preventative 2. primary 3. secondary 4. tertiary 5. Restorative 6. continuing
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primary/preventative
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- focuses on improved health outcomes for an entire pop. - requires collaboration among health care professionals
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Secondary and tertiary
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- also referred to as acute care - focus is diagnosis and treatment of the disease - settings include hospitals, ICU, PSYCH care and
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Restorative care: 3 types: 1. Home care 2. Rehabilitation 3. Extended care
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- helps ind. regain max function - promotes independence - requires multidisciplinary approach
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restorative care (home care)
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- Provision of medically related professional and paraprofessional services and equipment to patients and families in their homes. - Focuses on patient and family independence -Usually reimbursed by government (such as Medicare and Medicaid in the United States
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Restorative ( rehabilitation)
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- Focus: To restore patients to their fullest physical, mental, social, vocational, and economic potential - Includes physical, occupational, and speech therapy, as well as social services
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Restorative (extended care) and (skilled nursing facility)
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Provides intermediate medical, nursing, or custodial care for patients recovering from acute illness or disabilities. Provides care for patients until they can return to their community or residential care location
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Continuing care/ Nursing Centers or Facilities 4 types: 1. Assisted Living 2. Respite Care 3. Adult Day Care Centers 4. Hospice
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- for disabled, functionally dependent, or suffering a terminal disease. - Provide 24-hour intermediate and custodial care -Nursing, rehabilitation, diet, social, recreational, and religious services Residents of any age with chronic or debilitating illness
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Assisted living
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- Offers a long-term care setting with a home environment and greater resident autonomy - Provides services such as laundry, assistance with meals, personal care, housekeeping, and 24-hour oversight
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Respite care
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-The service provides short-term relief or "time off" for persons providing home care to an ill, disabled, or frail older adult.
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Adult day care centers
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- Provide a variety of health and social services to specific patient populations who live alone or with family in the community. - Offer services to patients such as daily physical rehabilitation and counseling
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Hospice
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- Family-centered care that allows patients to live and remain at home - Focuses on palliative (not curative) care: comfort, independence, and dignity - Provides patient and family support during terminal illness and time of death - Many hospice programs provide respite care
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Domain of Nursing
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-Is the perspective of a profession - Domain of nursing provides both practical and theoretical aspects of the discipline
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Nursing paradigm
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-Links person, health, environment/situation, and nursing
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Nursing theory
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-Is a conceptualization of some aspect of nursing -Describes, explains, predicts, and/or prescribes nursing care
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Types of Theories: 1. Grand 2. middle range 3. Descriptive 4. Prescriptive
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1. Broad in scope, complex, require specification 2. More limited in scope and less abstract 3. Describe phenomena, speculate on why phenomena occur, and describe the consequences of phenomena. 4. Address nursing interventions for a phenomenon, and predict the consequence of a specific nursing intervention.
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GOAL OF NURSING KNOWLEDGE
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explain the practice of nursing as different and distinct from the practice of medicine, psychology, and other health care disciplines.
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Interdisciplinary Theories
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Explain systematic views of phenomena specific to the discipline of inquiry:
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Self-Care Deficit Nursing Theory (SCDNT)
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- All actions are deliberate and are performed to achieve desired ends -Self-care is a regulatory human function - Nursing is an art, a helping service and a technology
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Universal Self-Care Requisites
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-Maintenance of sufficient intake of air -Water -Food -Care associated with elimination -Maintenance of balance between activity and -- -rest -Prevention of hazards -Promotion of functioning -Development within social groups
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1. Wholly compensatory 2. Partly compensatory 3.Supportive developmental
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1.When the nurse has to do everything 2. Nurse and patient engage in meeting self-care needs 3.Assistance in decision making, behavior control and acquisition of knowledge and skills
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Nursing knowledge is theoretical and practical. 1. theoretical knowledge 2. Experiential knowledge
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1. stimulate thinking and create a broad understanding of the "science" and practices of the nursing discipline 2.the "art" of nursing, is based on nurses' experiences in providing care to patients.
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Six standards of practice:
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Assessment Diagnosis Outcomes identification Planning Implementation Evaluation
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characteristics of a profession
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-Requires an extended education -Requires a body of knowledge -Provides a specific service -Has autonomy -Incorporates a code of ethics
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Benner's stages of nursing proficiency:
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- Novice - Advanced beginner - Competent - Proficient - Expert
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Nurses now:
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provide care and comfort and to emphasize health promotion and illness prevention
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Quality and Safety Education for Nurses (QSEN)
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- patient centered care - teamwork and collaboration - evidence based practice - quality improvement - safety - informatics
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Steps to evidence-based practice
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1. Ask the clinical question 2. collect the best evidence 3. critique the evidence 4. integrate the evidence 5. evaluate the practice decision or change 6. share the outcomes of EBP changes with others.
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P.I.C.O.T. question
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P.= patient population of interest I. = intervention of interest C.= comparison of interest O= outcome T= time
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These ind. are a rich source of evidence b/c they use it frequently to build their own practice and to solve clinical problems
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Expert Clinicians
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This includes determining the value, feasibility, and usefulness of evidence in making a practice change
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Critique of evaluation of evidence
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Analysis of Evidence All article for a Picot question should include :
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- synthesize or combine the findings - consider the scientific rigor of the evidence and - whether it has application in practice
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Integrations of evidence
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consider the setting and whether support is provided from staff and avail. resources - Evaluate the change. - Share the information.
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This council supports the need for nursing research as a means of improving the health and welfare of people
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ICN ( international council of nurses)
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What does outcomes management research do?
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- Designed to assess and document the effectiveness of health care services and interventions - A response of the health care industry to demands from policy makers, insurers, and the public - Outcomes must be observable or measurable.
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Scientific Method
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- The foundation of research - The most reliable and objective means of acquiring and conducting research and gaining knowledge. - A step-by-step process to ensure that findings from a study are valid, reliable, and generalizable to a similar group of subjects
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Nursing research
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provides a way for nursing questions and problems to be studied in broader context. - Quantitative - Qualitative - Quantitative types: historical, exploratory, evaluation, descriptive, experimental, correlational
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What is the research process/ Name the steps
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An orderly series of steps that allows a researcher to find the answer to a question 1.Identify problem. 2.Design study. 3.Conduct study. 4.Analyze data. 5.Use the findings.
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Informed content means?
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-Participants receive full and complete information -They can understand the information -They have free choice to participate -They understand how their confidentiality will be kept
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What do developmental theories do?
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- propose ways to account for how and why people grow as they do. - provide a framework for examining, describing and appreciating human development. - help nurses assess and treat a patient's response to illness.
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Definition of growth
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encompasses the physical changes across a person's life span.
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Definition of development
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A progressive and continuous process of change
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The developmental processes includes what kind of processes?
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1.Biological processes - Physical growth and development 2.Cognitive processes - Intelligence, understanding, thinking 3.Socioemotional factors - Personality, emotions, relationships with others
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Psychoanalytical/Psychosocial Theories
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- Describe development from personality, cognitive, and behavioral perspectives - Explain development as primarily unconscious and influenced by emotion
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Freud
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Sigmund Freud believed that the human personality consists of id, ego, and superego. He identified five stages of development: Stage 1: Oral (birth to 12 to 18 months) Stage 2: Anal (12 to 18 months to 3 years) Stage 3: Phallic or Oedipal (3 to 6 years) Stage 4: Latency (6 to 12 years) Stage 5: Genital (puberty through adulthood)
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Resell's theory of development
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-Growth and development is unique and is directed by gene activity. -Maturation follows a fixed developmental sequence -Human growth: 1.Cephalocaudal 2.Proximodistal
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Childhood temperaments
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- the easy child - the difficult child - slow to warm up child
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Life span perspective
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Human development is lifelong, although changes are slower
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Erikson's Psychosocial Stages
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Stage 1: Trust versus mistrust (birth to 1 year) Stage 2: Autonomy versus shame and doubt (1 to 3 years) Stage 3: Initiative versus guilt (3 to 6 years) Stage 4: Industry versus inferiority (6 to 11 years) Stage 5: Identify versus role confusion (puberty) Stage 6: Intimacy versus isolation (young adult) Stage 7: Generative versus self-absorption and stagnation (middle age) Stage 8: Integrity versus despair (old age)
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Stage-crisis theory (Havinghurst)
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focuses on resolution of tasks: - Owing to physical maturation - From personal values - From societal pressures -Activity theory of older adulthood
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Selective optimization with compensation theory
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as individuals age, they are able to compensate for some decreases in physical or cognitive performance by developing new approaches.
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Socioemotional selectivity theory
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that as people age, they become more selective and invest their energies in meaningful pursuits.
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Cognitive developmental theories
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Jean Piaget's four stages: Period I: Sensorimotor (birth to 2 years) Period II: Preoperational (2 to 7 years) Period III: Concrete operations (7 to 11 years) Period IV: Formal operations (11 years to adulthood)
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Moral Developmental Theory
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-Attempts to define how moral reasoning matures for an individual -Refers to changes in a person's thoughts, emotions, and behaviors that influence the perception of right or wrong
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Kohlberg's Moral Developmental Theory
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-Level I: Preconventional reasoning, when children ask WHY. Stage 1 = Punishment and Obedience Orientation: Children view illness as a punishment. Stage 2 = Instrumental Relativist Orientation -Level II: Conventional reasoning, when moral reasoning is based on internalization of societal and others' expectations Stage 3 = Good Boy-Nice Girl Orientation Stage 4 = Society-Maintaining Orientation -Level III: Postconventional reasoning occurs when a person finds a balance between basic human rights and obligations and societal rules and regulations. Stage 5 = Social Contract Orientation Stage 6 = Universal Ethical Principle Orientation, where right is defined by the decision of conscience in accord with self-chosen ethical principles.
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Examples of nursing diagnoses applicable to patients with developmental problems include:
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- Risk for delayed development - Delayed growth and development - Risk for disproportionate growth
