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1
Q

The critical care nurse has just listened to a lecture on standards of professional performance. The nurse then agrees to serve as a preceptor for undergraduate nursing students who are scheduled for observation in the critical care unit. Which statement by the critical care nurse indicates an understanding of the standards of professional performance?

a. “Professional standards include contributing to the professional development of others.”
b. “Professional standards include providing leadership in the practice setting.”
c. “Professional standards include using clinical inquiry in practice.”
d. “Professional standards include using skilled communication to collaborate with others.”

A

a. “Professional standards include contributing to the professional development of others.”

Precepting students is an example of contributing to the professional development of others. It is also an example of assuming leadership, but contributing to the development of others is the best response. The preceptor will probably use skilled communication in the professional development activities. It is not an example of clinical inquiry, which refers to applying research in practice.

2
Q

The charge nurse is making assignments for the critical care unit and assigns the experienced nurse to care for two complex patients. The novice nurse is assigned to care for the less complex patient. The charge nurse is basing assignments on which model of practice?

a. Institute for Healthcare Improvement
b. Quality and Safety Education for Nurses
c. Synergy model
d. Universal care

A

c. Synergy model

The synergy model of care states that the needs of patients and families influence and drive competencies of nurses, which improves client care. The Institute for Healthcare Improvement is an organization aimed at creating a safer health care environment. Quality and Safety Education for Nurses is an initiative to implement quality and safety content in nursing education programs. Universal care is a model of delivery in which patients remain on one unit and the level of nursing assignment changes.

3
Q

The nurse is interested in pursuing critical care nursing practice as a career. After listening to an explanation of critical care nursing, which statement indicates understanding?

a. “Collaborative practice interferes with effective patient care.”
b. “Critical care nurses coordinate care for critically ill patients in a variety of settings.”
c. “Critical care nursing is defined as care rendered in an intensive care unit.”
d. “Technological advances have had little effect on ethical dilemmas.”

A

b. “Critical care nurses coordinate care for critically ill patients in a variety of settings.”

Critical care nurses practice in varied settings to manage and coordinate care for patients who require in-depth assessment, high-intensity therapies and interventions, and continuous nursing vigilance. Collaborative practice helps promote effective patient care; it does not interfere with it. Critical care nursing is concerned with human responses to life-threatening problems, such as trauma, major surgery, or complications of illness. It is not confined to a specific nursing unit. Technological advances have resulted in increased ethical dilemmas in critical care practice.

4
Q

What is the synergy model?

A

Creating a health care system driven by the needs of patients and families in which critical care nurses make their optimal contributions, which is described as synergy.

5
Q

What are the publications of the AACN?

A

1) Critical Care Nurse
2) American Journal of Critical Care
3) AACN News
4) AACN Advanced Critical Care

6
Q

What are the publications of the SCCM?

A

1) Critical Care Medicine
2) New Horizons: The Science and Practice of Acute Medicine
3) Pediatric Critical Care Medicine

7
Q

QSEN 6 core competencies

A

1) Patient-centered care
2) Teamwork and collaboration
3) Evidence-based practice
4) Quality improvement
5) Informatics
6) Safety

8
Q

What are the components of a healthy work environment?

A

1) Respect
2) Responsibility
3) Acknowledgment of the unique contributions of patients, families, nurses, and health care team members
4) Effective decision making
5) Appropriate staffing
6) Meaningful recognition
7) Authentic leadership
8) Communication
9) Collaboration

9
Q

Barriers to effective handoff communication include?

A

1) Physical setting: background noise, lack of privacy, interruptions
2) Social setting: Organizational hierarchy and status issues
3) Language: differences between people of varying racial and ethnic backgrounds or geographic areas
4) Communication medium: limitations of communications via telephone, e-mail, paper, or computerized records versus face to face

10
Q

Suggested content of the morning briefings include answers to three questions:

A

1) What happened during the night that the team needs to know? (adverse events, admissions)
2) Where should rounds begin? (sickest patient who needs most attention)
3) What potential problems have been identified for the day (staffing, procedures)

11
Q

Strategies for nurses to maintain currency in the ever changing critical care environment

A

1) Reading professional journals
2) participating in journal clubs
3) becoming involved in unit based practice councils
4) attending local and national professional meetings

12
Q

Trends and issues with older adults

A

1) more chronic illnesses
2) develop multisystem organ failure which requires longer hospital stays, increases cost, and increases need for intensive nursing care