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EVIDENCE BASED PRACTICE > EBP > Flashcards

EBP Flashcards

(90 cards)

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1
Q

What are the 4 themes in the NMC code

A

Prioritise people, practise effectively, preserve safety and promote professionalism and trust

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2
Q

What is nursing?

A

A profession/ calling
intrinsic
Service to others
Requires specialist skills and knowledge FLORENCE NIGHTINGALE

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3
Q

Explain the regulation for nurses

A

NMC- protect the public
Maintain a register
Giving a protected title to nurses
Establishing how fitness to practise would function and be in action
Made it an offence for someone to falsely represent themselveslvez as being on the register

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4
Q

Public perception of nurses

A

:) all angels and do no wrong

:( not caring, scandals- mid Staffordshire report- poor care, poor attitude, poor communication, incompetence

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5
Q

What do patients want from their care?

A

Be treated well
Have high quality care
Nurses that keep them safe physically and mentally
Treated with compassion, respect and empathy
Treated as a person not a case

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6
Q

What is the purpose of the NMC?

A

Protect the public
Uphold fitness to practice
Sole funding Is by registration fees

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7
Q

What is the baseline of the NMC

A

The standard of below which professional practice must not fall below (education, training, conduct and performance)

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8
Q

What is the focused role of the NMC?

A

Define standards
Mentor adherence to standards
Act when standards are not being met

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9
Q

Where does confidentially arise from?

A

autonomy

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10
Q

What is confidentiality?

A

Implied promise healthcare professionals won’t go and spill their info.

The right that the persons medical info etc is kept secret (Apart from the healthcare team however they will only need to know what they need to know)

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11
Q

Why is trustworthy so important?

A

Without trust the relationship between the healthcare professional and the patient would break down and if the patient does not share necessary info then the healthcare professional cannot do their job

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12
Q

What is consequentialism?

A

Theory that suggests that actions should be determined by the consequences- the healthcare should be guided to bring out the greater good for the greatest amount of people.
Consequence could be wrong for the patient even if it is the right treatment!

Eg if the professional divulges confidential info then the patient may not seek healthcare again

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13
Q

What is the Caldicott Review?

A

Ensures that information that can identify an individual is protected and that information can only be used when it is appropriate to do so.

Eg must have a justified purpose
Must be necessary to give information to another healthcare professional
Access should be a strict need to know basis
Comply with law

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14
Q

When can you share information with others?

A

When a patient gives consent for info about their care and treatment to be shared with family members
THEY MUST BE COMPETENT, know what is going to be disclosed, reasons for disclosure, consequences, whom, and how much info will be given

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15
Q

When can you share info with others?

A

When a court law requires it

Public interest must be balanced with the private interest in maintaining confidentiality

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16
Q

What is safeguarding?

A

Protecting vulnerable people from harm

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17
Q

What happens if there is a safeguarding issue?

A

NMC must act if you think a patient is in danger, go higher and report it to safeguarding

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18
Q

What is paternalism?

A

Paternalism is when you interfere with someones autonomy, with the intent of preventing harm or promoting good.
Doctors will sometimes withhold info from their patient

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19
Q

What is candour?

A

Being open, honest, transparent.

If harmed by healthcare the professionals must inform patient and must offer a remedy

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20
Q

Describe being open

A

Allowing concerns and complaints to be raised without fear

Making sure that questions are answered

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21
Q

Describe being transparent

A

Sharing info with staff, the regulators and the public about the performance

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22
Q

Who should apologise

A

The person that made that mistake

Lead clinician even if it isn’t their fault

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23
Q

Describe the professional duty of candour process

A

1) Tell patient when something has gone wrong
2) Apologise to patient and family
3) Offer an appropriate remedy
4) Explain fully to the patient- STM and LTM effects

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24
Q

Does saying sorry mean you accept legal liability?

A

NO- right thing to do and shows regret

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25
What are the 3 things a patient expects in an apology?
What happened What can be done to deal with harm caused What will be done to prevent someone else being harmed
26
When should you say sorry?
In a way they can understand At a time and place that suits them Be considerate and respectful
27
What are notifiable incidents?
Any unexpected or unintended incident that causes moderate harm or worse
28
What is a near miss?
An adverse incident that had a potential to cause harm but didn't
29
What is a regulator?
CQC- carry out regular inspections that determine whether or not standards are being met for safe, effective, compassionate and high quality care
30
What is nursing care?
The provision of care where a patient needs to be provided for- not just by a nurse
31
What are regulated activities
``` Personal care Accommodation Treatment of diseases Surgical procedures Maternity and midwifery services Nursing care ```
32
What are the 2 types of harm?
Moderate and severe
33
What is moderate harm?
Requires a moderate increase in treatment eg unplanned surgery, increase in care, prolonged time in hospital, transfer to another treatment
34
What is severe harm?
Permanent damage Lessening of sensory, physiological, psychological functions DEATH Not part of natural course of patients treatment
35
What is whistleblowing?
When a worker passes on info concerning a wrong doing to supervisor/ tutor
36
Why don't nurses raise concerns?
shunned, suspended, frightened, sacked, not action would be taken, loss of friendships
37
What is negligence?
Failure to take proper care over something Defendant was owed a duty of care The harm was caused by carelessness
38
What is duty of care?
A moral or legal obligation to ensure safety of others
39
What is the legal aspect of duty of care?
Off duty should only have duty of care if caused accident
40
What is the professional aspect of duty of care?
Off duty always have duty of care IF COMPETENT
41
What causes negligence?
If standard of care falls below the standard
42
When negligence is taken to court, who are judged against?
Against what a reasonable professional would do in the same situation
43
If I am a student nurse and was taken to court, who would I be judged against?
A newly qualified nurse
44
What are the four main ethical principles?
Autonomy Justice Beneficence Non-malificence
45
Describe autonomy
Right to make own decision and take actions based on personal views
46
Describe justice
Treat people equitably, distribute benefits and burdens fairly (Eg personalised treatment- people get the same right that they get the best treatment for them
47
Describe beneficence
Do right thing for the patient
48
Describe non-non-maleficince
Obligation not to inflict intentional harm | DO NO HARM
49
What is fact?
A fact that can be proven with evidence
50
What is opinion?
Personal, interpretations and cannot be verified with evidence
51
What is evidence based practice?
Finding the best information to inform your decision-making
52
What are the 3 things in EBP?
Clinical expertise, best research evidence, patient values and preference
53
What does EBP require?
Requires that decisions about health care are based on the best available, current, valid and relevant evidence
54
What happens when practice is not evidence based?
You will not be fit for practice
55
What is the pyramid of evidence?
1) Animal/ Lab studies 2) Case Report/ Case studies NO DESIGN. NO HUMANS 3)Case control studies 4)Cohort studies 5) Randomised PRIMARY STUDIES/ OBSERVATIONAL 6)Meta analysis SECONDARY
56
What are the 4 approaches for research?
Quantitive Qualitative Mixed methods Review
57
Describe qualitative data
Learn about people's experience through discussions/ interviews Gives insight and detailed descriptions
58
What is nursing?
Both a science and an art
59
Describe quantitive data
Uses a LARGE number of participants explores C+E Used to compare treatments Is to support fact based decisions for groups NOT INDIVIDUALS
60
What are both types of primary research?
Know the facts- informed and technically competent Need to change behaviour of patients
61
What makes research good?
``` Clear question Sound theoretical basis Logical Limits bias through recruitment Has implications ```
62
What is the research hierarchy?
1) single case study- used when there is no evidence= small sample size 2) Descriptive studies- Provide several viewpoints, use theoretical framework from previous case studies 3) Generalisable conceptual studies- larger diverse sample, provide info that can be applied to all
63
What come hand in hand with evidence when speaking to a patient
Trustworthiness- they have to trust the healthcare professional to listen to the advice/ evidence you're giving
64
What is your responsibility?
Professional responsibility to make evidence based decisions
65
What is the alternative to whistle blowing?
Invited criticism Culture that values feedback Multiple channels of disclosure
66
What is the research process?
1) Idea 2) Research question 3) Prioritising 4) Plan 5) Funding 6) Ethics approved 7) collect data 8) Analysing data 9) interpret data 10) tell people results 11) Change practice 12) re-evaluation
67
What is ethnography?
Understanding a culture within that culture, in the point of view of that culture participants observe unstructured Researching something from that cultures point of view
68
What is the grounded theory?
Make own theory Social processes Shows solutions
69
What is phenomenology?
Living in their world seeing it from their point of view study of lived experience researchers need to remove values/opinions
70
What are the data collection methods for qualitative research?
Interview Focus group Observation
71
Summarise qualitative data
Understand meaning Coloured by judgements but this can be a benefit gives insight and depth- peoples experience
72
What is face validity?
does the procedure look like its effective and will measure what its supposed to measure
73
What is construct validity?
degree of which a test measures what it claims to measure
74
What is criterion validity?
extent to which a measure predicts an outcome for another measurement
75
What is discriminate validity?
tests whether concepts/ measurements that are not supposed to be related are actually related
76
What are the levels of measurement for quantitive data?
nominal- categories ordinal- categories but have order within categories interval- difference between 2 values is meaningful ratio- same as interval but starts at 0
77
What is stratified sampling?
group random sample out of each group random population proportional
78
What is special about random sampling?
everyone has the exact same chance of being picked
79
What is purposive sampling?
Selective sampling- pick certain characteristics of population- stop when saturated
80
What is test re-test reliability?
Give same tests to same respondents and should get the same results
81
What is inter-rater reliability?
Degree of agreement among different raters
82
What is the process of qualitative data analysis?
Familarise yourself with data Generate codes Review themes
83
Describe the mid-staffordshire report
Neglect of patients- not washing, no water, dirty bed sheets changes: tougher inspections, recruited more nurses, able to speak out if have concerns, more transparency over treatment, put patients in driving seat
84
What is the ethical issues with informed consent?
Autonomy
85
What is informed consent?
Making sure a patient is making a right decision by ensuring they have sound understanding
86
How can you check if someone is giving informed consent?
Patient-teaching= check patient understanding by asking them to repeat what they understand Asses for paternalism
87
What is epidemiology?
studies that look at prevalent incidence or distribution of diseases
88
What is prevalence?
Proportion of a population who have a specific characteristic in a given time period
89
What is incidence?
measure of the number of new cases of a characteristic that develops in a population
90
What are the key concepts of research for quantitive research?
1) recruitment- define population, big sample 2) Sampling-random, convenience etc representative of pop 3) Data collection- valid and reliable way of collecting data 4) Data analysis- summarise data using statistical tests

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