NSG 403 – Flashcard

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American Society of Superintendents of Training Schools of Nursing:
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A national nursing organization founded in 1893 to elevate the standards of nursing education; later became the National League of Nursing Education, and ultimately, the National League of Nursing (NLN)
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Bolton Act of 1942:
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Legislation that created the U.S. Cadet Nurse Corps, a program subsidized by the federal government and designed to quickly prepare nurses to meet the needs of the armed forces, civilian and government hospitals, and war industries.
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Deaconesses:
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Women with some educational background who were selected by the church to provide care to the sick.
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Goldmark Report:
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Published in 1923, this report recommended that nursing education develop educational standards, schools of nursing adopt a primary focus of education and be moved to universities, and nurse educators receive advanced education.
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Mahoney, Mary
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The African American graduate nurse.
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Montag,Mildred:
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Developed the concept for associate degree in nursing programs
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Nightingale, Florence:
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The founder of professional nursing in England
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Nurse training school of Women's Hospital of Philadelphia
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Est. in 1872, reputed to be the first permanent school of nursing in the U.S
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Nurses' Associated Alumnae of the United States and Canada:
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Originally founded in 1896 with the intent of achieving liscensure of nurses; became the American Nurses Association (ANA
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Richards, Linda:
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Purported to be the first educated nurse in the United States, a graduate of the New England Hospital for Women and Children in Boston.
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St. Thomas' Hospital:
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A hospital in London where Florence Nightingale established the Nightingale School of Nursing.
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Wald, Lillian:
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A public health nurse who founded Henry Street Settlement House to provide home nursing care to the immigrant populations of the lower east side of New York.
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Dorothea Dix:
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(1802-1887) superintendent of Union Army nurses during the war. She was a teacher and reformer of mental hospitals who, at the outbreak of the war, was charged with recruitment of nurses and supervision of nursing activities.
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Clara Barton: (My professor repeated her name several times)
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(1821- 1912) a volunteer nurse who served in battlefield hospitals and prisoner of war camps. Following the war, she founded and became the first president of the American Red Cross.
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Harriet Tubman:
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(1820-1913) born into slavery, escaped to Philadelphia. During the war she nursed soldiers using herbs and other home remedies.
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Louisa May Alcott:
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(1832-1888) an author and volunteer nurse for the Union Army. Her book "Hospital Sketches", which was based of letters she had written home from an army hospital, aroused public awareness of the work of nurses in the grim environments of military hospitals.
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Linda Richards:
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(1841-1930) Awarded the title "America's first trained nurse." She was the first graduate of the year-long nurse-training program in Japan, and then returned to the United States to found nurse-training programs in Michigan, Massachusetts, and Pennsylvania.
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Licensure for Nurses: 1901
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They were "permissive" in that only nurses who were licensed were permitted to use the title "registered Nurse." Thus, untrained persons were not prohibited from practice as nurses as long as they did not use the title "registered nurse"
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Advances in Nursing Practice
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By the 1970's, clinical specialist roles had been developed in a variety of nursing practice areas including psychiatric/mental health nursing, cardiac nursing, oncology nursing, and community health nursing.
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Apprenticeship Model:
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A model of nursing education that was prevalent during the first half of the 20th century, where student nurses learned nursing practice by providing service to hospitals.
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National League for Nursing Education (NLNE):
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A professional organization in nursing that fostered excellence in nursing education by supporting nursing education research, engaging in policy making and advocacy efforts related to nursing education, and promoting faculty development. It was the precursor to the National League for Nursing.
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Ginzberg Report (1949)
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which suggested that in comparison to a 4-year nursing program it would be more efficient and economical for colleges to offer a 2-year course of study in nursing. Ginzberg believed that not all nurses needed baccalaureate education to provide patient care.
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American Nurses Association (ANA)
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In 1965, the American Nurses Association (ANA) published a position paper stating that those licensed to practice nursing should be prepared in institutions of higher education (universities). It also stated that the minimum preparation for the professional nurse should be a baccalaureate degree.
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Nightingale School:
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Schools of nursing developed by Florence Nightingale that promoted student nurses learning the theory and practice of nursing outside of the Hospital control.
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Nightingale advocated for nursing students to learn sound theory in:
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anatomy and physiology, surgery, chemistry, nutrition, sanitation, and professionalism; to train under the guidance of ward sisters who were nurses with experience and dedication to the profession; and to be part of a system that was financially independent from hospitals.
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American Association of Colleges of Nursing (AACN)
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A professional organization in nursing that serves baccalaureate nursing and higher degree nursing education programs by influencing the quality of nursing education and practice through research, advocacy efforts, policy making, development of quality educational standards and indicators, and faculty development.
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Mobility Programs (also known as education mobility or career ladder programs)
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enable individuals to enter the nursing profession from different educational points or pursue professional career development through additional academic preparation without losing credits from previous degree work.
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National Council Licensure Examination for Registered Nurses (NCLEX-RN)
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This examination must be taken by all graduated of diploma, associate degree, and baccalaureate degree nursing programs prior to a license being issued. Successful completion of the NCLEX-RN is a requirement for practice as a registered nurse.
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National Council of State Board of Nursing (NCSBN)
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the body given the task of providing a means to ensure that those who are licensed to practice as nurses are "safe" in terms of their knowledge base. Page 64&65
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Computer Adaptive Testing
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An interactive testing format used on the NCLEX-RN to adjust the type of question and level of testing difficulty based on the test taker's previous response. In the NCLEX-RN examination, the testing continues until the student either achieves a consistent level of test item difficulty that indicates a satisfactory performance level and passing of the examination, does not achieve a consistent level of testing difficulty required to indicate a satisfactory performance level and thus fails the examination, or completes all the test items of the examination or time expires of the test.
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Formats for NCLEX-RN
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multiple response, fill-in-the-blank/ calculations, hot spots, exhibits, and drag and drop/ ordered response items.
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Nurse practice Act:
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A state statute that defines the legal limits for the practice of nursing within that state and explicitly identifies the requirements for licensure.
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Nurse Licensure Compact (NLC)
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A form of interstate compact specific to nurse licensure that provides an agreement between two or more states for the purpose of recognizing nurse licensure between and among a group of participating states. States must enter into an NLC in order to achieve mutual recognition.
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NLC
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Although nursing licensure is tied to the nurse's state of primary residence, accountability for nursing practice is tired to the laws and regulations of the state where a patient is located at the time nursing care and services are rendered.
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Standard Care:
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the degree of care, expertise, and judgement exercised by a reasonable person under same of similar circumstances.
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Performance Outcomes:
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A predetermined set of goals that are met consistently when the same standards of care a given
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Joint Commission:
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The joint commission is the nation's predominant standards-setting and accrediting body in health care. The Commission's comprehensive accreditation process evaluates an organization's compliance with quality and safety standards and other accreditation requirements.
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Institute of Healthcare Improvement (IHI)
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The Institute for Healthcare Improvement (IHI) is a non-profit organization leading the improvement of health care throughout the world.
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Institute for healthcare improvement campaign initiatives:
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1. Deploy Rapid Response Teams: at the first sign of patient decline 2. Deliver Reliable, Evidence-Based Care For Acute Myocardial Infarction: to prevent deaths from heart attack 3. Prevent Adverse Drug Events (ADEs): by implementing medication reconciliation 4. Prevent Central Line Infections: By implementing a series of interdependent, scientifically grounded steps 5. Prevent Surgical Site Infections: by reliably delivering the correct perioperative antibiotics at the proper time. 6. Prevent Ventilator-Associated Pneumonia: by implementing a series of interdependent, scientifically grounded steps. 7. Prevent Harm from High-Alert Medications: starting with a fovus of anticoagulants, sedatives, narcotics, and insulin. 8. Reduce Surgical Complications: by reliably implementing all the changes in care recommended by SCIP, the Surgical Care Improvement Project. 9. Prevent Pressure Ulcers: by reliably using science-based guidelines for their prevention 10. Reduce Methicillin-Resistant Staphylococcus Aureus (MRSA) infection: by reliably implementing scientifically proven infection control practices. 11. Deliver Reliable, Evidence-Based Care for Congestive Heart Failure: to avoid readmission 12. Get Boards on Board: by defining and spreading the best-known leveraged processes for hospital Boards of Directors, so that they can become fare more effective in accelerating organizational progress toward safe care.
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Core Measures:
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Used to measure the quality of care provided by a hospital and its providers for clients with a specific diagnosis such as heart failure, pneumonia, or acute myocardial infarction. These measures are determined by the center for medicare and medicaid services (CMS), The joint commission, and the American Hospital Association.
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National Database of Nursing Quality Indicators (NDNQI)
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The American Nurses Association (ANA) established the National Database of Nursing Quality Indicators (NDNQI) in 1998. It is maintained by the Kansas University Medical Center School of Nursing. Participating hospitals use the database to collect and report unit-specific data. Members receive relevant national comparative data and annual trended comparisons. Nursing-sensitive indicators reflect the structure, process, and outcomes of nursing
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Nursing-Sensitive Indicators From NDNQI
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refer to page 208
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Magnet Status:
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The Magnet Recognition Program, established by the American Nurses Credentialing Center in 1993, recognizes healthcare organizations that demonstrate excellence in nursing practice and adherence to national standards for the organization and delivery of nursing services.
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Forces of Magnetism as Designated By the American Nurses:
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-Quality of nursing leadership -Organizational structure -Management style -Personnel policies and programs -Professional models of care -Quality of Care -Quality improvement -Consultation and Resources
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Family
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A group of individuals that interact together, share common beliefs and values, and care and relate to each other. Families are connected by their relationship with each other and they may change structurally over time.
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Healthcare Delivery System
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A mechanism for providing services that meet the health needs of individuals
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Home health services.
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An array of allies professional and paraprofessional services and assistive equipment provided to clients and families int heir homes.
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Hospice
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Incorporates special services that address the unique needs of dying people and their families. Medical, spiritual, legal, financial, and family support services are provided.
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Managed care:
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Administrative control over primary healthcare services for a defined client population.
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Managed care organization (MCO)
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Receives a predetermined capitated payment for each client enrolled in the program.
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Medicaid:
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A grant program or government insurance plan providing partial healthcare services for indigent people.
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Medicare:
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Similar to Social Security, Medicare is an entitlement program. Individuals have contributed toward Medicare via taxes. People over the age of 65 years and some chronically ill persons are entitled to the health benefits regardless of their income and assets.
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Parish nurses:
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Promote holistic health and healthy lifestyles for the church community members they serve.
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Respite care:
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A service that provides temporary relief to informal caregivers such as family members who care for children, psychiatric clients, or frail older adults.
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History and Background of Evidence-Based Practice:
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page 240. Florence Nightingale (1957) applied evidence to practice in the 19th century. "Notes on Nursing", originally published in 1859, was an early version of EBP.
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PICO Format
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P= Patient population (i.e., adolescent women) I= Intervention of interest (abstinence education) C= Comparison intervention (oral contraceptives) O= Outcome (prevention of pregnancy)
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Difference between EBN ; EBP
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EBN follows the principles of EBP and includes the four elements of evidence-based decision making for nursing care: best research evidence, clinical expertise, patient preferences in their specific situation, and available resources for nursing assessment and interventions. EBN additionally considers ethical and cultural aspects, psycho-social issues, and family considerations in clinical care decisions.
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Case-control studies:
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research that retrospectively compares the characteristics of one individual with certain medical conditions to another who does not have the medical condition.
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Clinical care protocols:
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clinical practice guidelines that reflect the most up-to-date practice based on evidence for reference and knowledge with the goal of having the latest scientific knowledge available to clinicians to make decisions about care. Elements include systematic literature review, and the consensus of expert decision makers and consumers who consider the evidence and make recommendations
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Controlled trial
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research in which ther is a treatment group and a group that does not receive the treatment (control group) so that comparisons can be made about the effectiveness of an intervention on a specific health issue and health outcome.
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Descriptive studies:
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Research conducted in order to describe characteristics of selected variables or a certain phenomenon.
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Evidence-Based nursing (EBN)
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Clinical decision making by nurses that is a combination and integration of the best research evidence; it also includes the nurse's clinical expertise and patient values and preferences about a specific type of care.
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Evidence-Based Practice (EBP)
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The process of problem solving using the best research evidence in clinical decision making for patient care. It is a combination of a systematic search for and critical appraisal of the most relevant research available to answer a specific clinical question, with the clinician's own clinical expertise and patient values and preferences included.
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Meta-analysis
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The summarization of the results of several quantitative studies critically reviewed, synthesized, and evaluated to answer a specific clinical question about the effectiveness of an intervention across multiple studies in different settings.
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Qualitative study
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A descriptive type of research in which variables are not quantifies numerically to describe a phenomenon of interest. Data are obtained through open-ended questions of interviews.
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Randomized controlled trial (RCT)
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Experimental research that is the strongest design to support a cause and effect relationship. Subjects are randomly assigned to a treatment group or a control group.
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Systematic Review:
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Summary of evidence obtained by researchers on a specific topic or clinical problem. It uses a step-by-step rigorous process to identify, synthesize, and evaluate research studies to answer a specific clinical question and to make conclusions about best evidence.
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Four Elements of Negligence:
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1. The defendant owed a duty to the plaintiff to use reasonable care 2. The defendant failed to conform to this standard of care (known as breach of duty) 3. There is a reasonably close causal relationship between the defendant's conduct and the plaintiff's injuries (a two part test) and; 4. The plaintiff suffered actual loss or damages
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Exceptions which may allow disclosure of confidential information:
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1. The patient gives verbal or written permission to release information 2. Other healthcare workers who have a legitimate reason to know information (e.g. report to charge nurse); 3. Statutory or legal duty to report (e.g. communicable diseases, child abuse, gunshot wounds, etc.) 4. There is a duty to warn (e.g. serious threat to an identifiable victim)
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Breach of Duty:
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Failure to perform according to a specific standard of care once a duty is established
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Causation:
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A determination that if not for the conduct of the defendant, the plaintiff would not have been injured and that the consequences of such conduct were foreseeable.
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Civil Law:
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Law that dictates behavior between parties.
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Common Law:
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Law that develops as a result of judicial decision; also known as case law.
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Consent:
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A patient's acquiescence to care; it must be informed, voluntary, and competently made in order to be valid
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Damages:
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Injuries incurred as a result of someone's negligence.
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Delegation:
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Handing over of a licensed activity, as defined by the state's nurse practice act, to an unlicensed person.
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Duty:
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An obligation to act or refrain from acting
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Good Samaritan Law:
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A law enacted by a state that protects healthcare providers and other rescuers from liability if they render aid in an emergency, provided that they use reasonable and prudent judgment under the circumstances based on their education, training, and skill level
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License:
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Permission to engage in an activity; a professional license allows the holder to engage in a specific activity for compensation.
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Licensure:
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The process by which a state of government agaency grants permission to an individual to engage in a giver profession for compensation.
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Mutual recognition model:
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Allow a nurse to maintain a license in his or her state of residency and to practice and be recognized in another state, subject to each state's practice law and regulation; also known as the nursing interstate compact.
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Negligence:
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Unintentional conduct that falls below a standard of care established for the protection of others against unreasonable risk of harm.
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Professional Malpractice
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A type of negligence that results when a professional person fails to perform his or her professional duties in a reasonable manner.
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Respondeat superior
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A legal doctrine which holds that the employer is responsible for the actions of its employees that occur within the scope of the employment relationship
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Self-determination:
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The right of every individual to control his or her own person free from interference from others.
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Patient Safety
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Freedom from accidental injury
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Medical error
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Failure of a planned action to be completed as intended, or the use of a wrong plan to achieve an aim
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IOM Report
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released in 2000. Report stated that tens of thousands of Americans die each year from errors in medical care and hundreds of thousands are injured, or almost injured, during their care.
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IOM Goals
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Health care should be: Effective Patient-centered Timely Efficient Equitable
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Complex Systems
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Systems in which work includes both cognitive and physical demands and is characterized by dynamism, large numbers of parts and connectedness between parts, high uncertainty, and risk.
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Culture Safety
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Shared values and beliefs in an organization that interact with the organizational structures and systems and produce behavioral norms surrounding work
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Reporting System
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A safety information system that collects, analyzes, and disseminates information about near misses, adverse events, and safety systems.
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Box 8-2 page 171
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New look principles for improving patient safety 1.Safety is made and broken in systems, not by individuals. 2. Progress on safety begins with understanding technical work. 3. Productive discussions of safety avoid confounding failure with error. 4. Safety is dynamic and not static; it is constantly renegotiated. 5. Trade-offs are at the core of safety
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Quality and safety education for nurses (QSEN)
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Quality and Safety Education for Nurses is an initiative funded by Robert Wood Johnson Foundation with the goal of fostering commitment to the IOM- recommended quality and safety competencies within the nursing profession.
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Culture
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The values, beliefs, customs, social structures, and patterns of human activity and the symbolic structures that provide meaning and significance to human behavior.
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Culturally competent Health Care
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The ability to deliver health care with knowledge of and sensitivity to cultural factors that influence that health and illness behaviors of an individual client, family, or community
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Race
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A social classification that denotes a biologic or genetically transmitted set of distinguishable physical characteristics.
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Ethnicity:
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Designation of a population subgroup sharing a common social and cultural heritage.
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Stereotyping
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Consigning cultural attributes to a group of people based on assumptions, opinions, or attitudes.
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Health care providers develop the kills for a patient-centered approach that does the following:
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1. Assesses core cross-cultural issues 2. explores the meaning of the illness to the patient 3. determines the social context in which the patient lives 4. engages in a negotiation process with the patient
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Bernal's FIVE components for developing cultural sensitivity:
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1. open-mindedness, 2. awareness of ones's own cultural values 3. understanding of differences 4. knowledge 5. Adaptation skills
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Cultural Diversity and health Disparities
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Despite the fact that humans are 99.9 percent identical at the DNA level, there are differences in prevalence of illness among groups.
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Services of a Translator
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1. Orient the translator to the topics to be covered, the client's situation, and the degree of accuracy required. 2. Observe the client for nonverbal communication that does not match the message intended and request clarification. 3. Slow down the communication process 4. Encourage the translator to let the nurse know when somethings is difficult to translate so that it may be reworded. 5. Limit the use of medical jargon, slang, and metaphors in order to reduce the chance for error. 6. Consider the impact of differences in gender, educational level, and socioeconomic status between the client and translator. This is particularly important when topics of a sensitive or personal nature are to be discussed.
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Code of ethics
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standards and behaviors of profession or organization directed towards its constituents
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Organizational ethics
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Ethical analyses and actions taken by healthcare organizations.
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Personhood
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Various religious and philosophical traditions have definitions of what constitutes a person. These need to be recognized and applied as necessary within a defined healthcare context.
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Professional Code of Ethics
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A code of ethics makes explicit the primary values and obligations of a given profession with a goal of assisting professionals
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Who created the first code of ethics for nurses
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Florence Nightingale. The "Nightingale Pledge"
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Four Principles for the code of ethics
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1. doing no harm to clients 2. benefiting others 3. Loyalty to clients 4. being truthful in all facets of practice.
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Sidebar 15-4 The underlying goals of ethics committees page 357
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1. To promote the rights of patients 2. To promote shared decision making between patients and their clinicians 3. To promote fair policies and procedures that maximize the likelihood of achieving good, patient-centered outcomes 4. To enhance the ethical tenor of healthcare professionals and healthcare institutions
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Social Policy
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Policy decisions that are made to promote the welfare of the public
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Political competence
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The skills, perspectives, and values needed for effective political involvement.
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Margaret Sanger
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Pioneering force in the field of contraception and helped create the International Planned Parenthood Federation.
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The Five Stages of skills acquisition
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1. novice 2. Advanced Beginner 3. Competent 4. Proficient. 5. Expert
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Critical Thinking
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A systematic process of assessing, grouping, and evaluating data to determine the best plan of action for each patient care issue. Defined as "thinking about all of the implications of and options for each issue of patient care"
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Five Rights of Delegation
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1. Identify the right task to delegate 2. Identify the right circumstances for Delegation 3. Select the right person for delegation 4. Use the right direction and communication when delegating
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Barriers in the Nursing Shortage
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Many individuals seeking to enter the profession cannot be accommodated in nursing programs due to faculty and resource constraints. The primary barriers to accepting all qualified students at nursing colleges and universities continue to be insufficient faculty, a limited number of clinical placement sites, and a lack of classroom space.
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Benchmark
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Quality performance measurement data shared among healthcare providers and organizations for quality improvement and safety. The National Committee for Quality Assurance (NCQA) maintains benchmarking data.
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Magnet
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A healthcare organizational environment that promotes a culture of professional development and quality patient outcomes within the global healthcare climate.
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Box 22-5 Page 547 Examples of strategies to integrate practice and research
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1. Create an evidence-based practice committee. 2. Require attendance at a yearly research conference for all nurses. 3. Form collaborative research teams consisting of faculty and clinicians. 4. Identify senior nurse researchers who will provide mentorship and over-sight to the clinical research 5. Require funding for research consultation in hospital operational budgets. 6. Establish monthly research grand rounds. 7. Encourage nurses to submit a clinically based study for a poster or presentation at a research conference. 8. Revise infection control and other policies and procedures to reflect the current literature for evidence. Cite literature references for all policies.
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The Magnet Program
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is based of research regarding quality indicators and standards of practice. The program can be viewed as a framework for dissemination of best practice strategies to professionals.
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