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Professional Role > Exam 1 > Flashcards

Exam 1 Flashcards

0
Q

Florence Nightingale

A
  • wealthy, Italian born 1820
  • deep concern for poor and suffering
  • age 31: attended 3 month training ing Germany
  • Crimean war: decreased death rates 42% to 2% by emphasizing sanitary conditions (principles of asepsis & infection control)
  • 1860: est. 1st nursing school in England (St. Thomas Hospital of London)
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1
Q

Clara Barton

A
  • civil war
  • founded American Red Cross
  • # of nurse training schools increased and process lengthened
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2
Q

Lilian Wald

A
  • health education, 1900- WWII
  • Henry settlement house -> education, disease prevention, occupational health
  • 1911: ANA standards were developed
  • CCNE: accreditation started
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3
Q

Duties of floor nurse in 1887 (box 1-2)

A
  • cared for 60 pts
  • maintain temp. of floor, sweep and mop
  • fill kerosene lamps
  • make pens carefully to write notes
  • gets an evening off (1 night/week) if attended church
  • smoke/drink/get hair done/go to dance halls: director will question worth
  • 5 cents/day pay raise if work for 5 yrs
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4
Q

Clara Mass

A
  • volunteered for medical experiments = PIONEER for experimental studies
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5
Q

When interacting w/ physicians

A
  • Act competent
  • Take responsibility & Talk concisely
  • Be HONEST if you don’t know something
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6
Q

QSEN (Quality Safety Education in Nursing)

A

Achieve knowledge, skills, and attitudes

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7
Q

HIMSS (Healthcare Management Systems Society)

A

Non profit organization

1961: how programs for charting are set up

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8
Q

IOM (Institute of Medicine)

A

Recommendations on healthcare RN-BSN level

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9
Q

HIPPA

A
  • protects patient’s privacy
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10
Q

Common errors & causes

A
  • meds, higher nurse-pt ratios, higher acuity(sicker), older/inexperienced nurses, remember 6 rights (check 3x)
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11
Q

Professional responsibilities

A

Competancies: continued educations hours
Certifications: license (every 2 yrs)- work related (2-3 yrs)
Insurance: recommended ~100/ yr
Organizations (could decrease insurance payments, typically cost $$$ to be a part of)

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12
Q

Nursing education programs

A

LPN: nursing homes, hospitals
Diploma: 1800s~ 2yrs in length
ASN: to produce quickly after we’re
BSN: 1924-> Yale University offered 1st program
MSN: Early 70s shifted to adv. Practice roles in clinical– clinical nurse leader (EBP)

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13
Q

Testing

A

NCLEX: RN, must pass to function as RN
NCSBN: writes NCLEX
Core competences: skills for safety (6 core for QSEN)

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14
Q

International Council of Nurse

A

Early 1900s -> passed resolution that each state examines & license their own nurse

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15
Q

Mandatory Licensure

A
  • NY: 20yrs later -> 1st state to require mandatory license to practice in NY
  • State board test: 1950 1st exam
  • NCLEX- RN Examination: used to be pencil- now computer
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16
Q

Nurse Practice Acts

A
  • Varies among states
  • Rules & Regulations w/in states
  • Passed by state legislature- specific for states
  • When to renew?/ What’s mandatory CE?/Punishments (narcotics/taking meds
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17
Q

State Board of Nursing

A
  • Establishes “rules” for nursing practice
  • Delegation - legal definitions of practice
  • Can become a member -> through govenor’s office
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18
Q

NCSBN (National Council of State Boards of Nursing)

A
  • nonprofit
  • health interest for public
  • license exams
  • board members & the territory around it
  • If you ant to work in another state (compact states)
  • Can be great differences b/w states
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19
Q

Physician’s role in the hx of health care financing

A
  • primary responsible for decision making
  • cost wasn’t discussed w/ pts
  • 1960s -> more procedures-> more $$ they made
  • 1965 -> once the 80s came, Dr.’s could bill what they wanted - then Medicare left to pay what is left - federal budget deficit
  • Medicare = >65, disabled, dialysis
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20
Q

Health Care Financing Revolution

A

1965: cost $202/person
2010: cost $8,402/person
Medicare
- Cost-shifting: insured people pay for people who are not insured

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21
Q

DRG’s

A
  • DRG’s: level out payment-code for each diagnosis (Reduces cost by decreasing length of stay)
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22
Q

Cost-shifting

A
  • insured people pay for people who are not insured
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23
Q

Development of Managed Care

A
  • HMOs: Health Maintenance Organizations
  • PPOs: Preferred Provider Organizations
  • POs: Point-of-Service
  • Managed care organizations
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24
Q

PPACA (The Patient Protection & Affordable Care Act)

A
  • Signed March 23,2010
  • Uninsured & Underinsured
    • Expand healthcare to uninsured, control costs & improve quality, 10
      yrs to be fully implemented
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25
Q

How healthcare is paid

A
  • combo. of private & public sources
  • Medicare 2008: new policy-> new policy- hard on hospitals & any
    preventable occurences- “Near” events they won’t pay for these
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26
Q

Outcome Management

A
  • Efficient care -> service cost & time (ex: 1 glove vs 3)

- Effective care -> successful outcome

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27
Q

Laws

A

“must” and “shall”- prohibiting or controlling certain behaviors- imprisonment

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28
Q

Ethics

A

“should” “may”- address beliefs about behaviors

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29
Q

EMTALA: 1986-> Anti-Dumping Laws

A
  • transferring unstable pts.- MUST STABILIZE before transferring
  • Has to receive a medical screen before transferred
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30
Q

Americans w/ Disabilities Act (1990)

A

end discrimination- remove barriers & make accommodations

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31
Q

Patient Self-Determination Act (1990)

A
  • participate in their own health care decisions
  • accept or refuse medical treatment
  • make advances health care directives
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32
Q

Health Insurance Portability & Accountability Act of 1996

A
  • confidentiality of the patient’s health information
  • Protects whistle-blowers
  • If you fax to wrong place can get a violation
  • “here & stable” is all you can say
  • Don’t send any patient info. to doctors through cell phone
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33
Q

State Stautes

A

In addition to federal laws, nursing practice is governed by state law

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34
Q

Violations of Nurse Practice Act

A

Alleged Actions

- Subject to disciplinary action, may revoke license/fine/probation

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35
Q

Reporting Statutes

A
  • nurses are required to report suspected abuse, unsafe or illegal practices
  • suspected or confirmed abus
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36
Q

Common Law

A
  • Nurses duty to prevent harm & not be negligent
    • If physician’s discharge order is wrong, nurse can get in trouble
      also
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37
Q

Civil Law

A

Tort (unintentional and intentional)

38
Q

Negligence

A

Failure to act in a reasonable & prudent manner (carelessness-unintentional)
- Ex. forget to tell nurse pt has low HR before leaving lunch

39
Q

Malpractice

A

Failure of a professional act in a reasonable & prudent manner

40
Q

Res Ipsa Loquitur

A

More serious–> foreign body left in after surgery

“Speaks for itself”

41
Q

Gross Negligence

A

Negligence is so reckless & reflects such a conscious disregard for the patient’s welfare that it represents gross negligence
(Ex: 3x dose of heparin)

42
Q

Criminal Negligence

A

Act is so ridiculous

Represents a case in which the negligent acts of the nurse also constitutes a crime

43
Q

Good Samaritan Immunity

A

RN held accountable for standard of care that any reasonable & prudent nurse would render (each state has one)

44
Q

Statutes of Limitations

A

2-3 yrs from date of patient’s injury or death

45
Q

Transparency & Disclosure of Error

A

Take responsibilty: go & tell the manager-may not be your fault- get your support before you dig yourself into a deeper hole

46
Q

Liability

A
  • Every person is responsible for the wrong or injury done to another resulting from carelessness
  • Floating to different floors (the nurse is ultimately responsible for the quality of care provided to each patient)–> CAN DECLINE
47
Q

Personal Liability for Team Leaders

A

Charge nurse to change - Charge nurses: delegation of task-triage-document if you ask a charge nurse to change your patient or if you are busy and ask for help CHART!!!
Managers: inadequate training, supplies

48
Q

Risk Management

A
  • job to reduce preventable patient injuries w/in the agency

- Report near misses & errors - different form for these - don’t put them in the chart

49
Q

Intentional Tort

A

The nurse violates a person’s legal rights & intended to perform the offensive act- “running your mouth”

50
Q

Assault & Battery

A

Assault: Causing fear to a person
Battery: Harmful or offensive touching of a person

51
Q

Defamation of character

A
  • Libel: Defmation c/b written work- don’t write demeaning things in the chart (“whiner”, drug-seeker)
  • Slander: Injury of one’s reputation c/b the spoken word (Don’t chart opinion-just list facts)
52
Q

False imprisonment

A
  • unlawful restraint or detention of another person against his or her will/wish
  • AMA Form -> leaving against medical advice
  • 6404 -> Psych pts held against will if signed
53
Q

Adv. Directives: POA/DNR & Living Wills

A
  • Right to die grants adults the right to refuse extraordinary medical tx when there is no hope of recovery
  • But if patient/family changes mind may overturn living will
54
Q

Informed Consents

A
  • Obtain a signed consent prior to procedures

- Very specific

55
Q

The Right to Refuse: Diagnostic Testing/Txs/Care

A

Patients can refuse tx & we can’t force it

56
Q

Use of physical restraints

A

Remember proper documentation of restraints! DOCTOR must sign

57
Q

Nurse Ethics

A

Care based on what should be done in keeping the values of the client

58
Q

Bioethics

A

Controversial ethics brought about by advances in biology & medicine

59
Q

Value

A
  • A personal belief about worth & acts as a standard to guide behavior
  • Diane Uustal-> value (evolving & changing as you age) & ethics
  • Right & Wrong -> how you were raised
60
Q

Right of Conscience

A

Euthanasia & Abortion

61
Q

Ethical Theory

A

Utilitarian (right if it leads to positive balance)

Deontology: consistent & objective to compel them to do what is right

62
Q

Autonomy

A

Respect of a person

63
Q

Beneficence

A

Promote goodness, kindness, charity

64
Q

Nonmaleficence

A

Duty to not inflict harm

65
Q

Veracity

A

Telling the truth

66
Q

Ethical Decision-Making Model

A

1) Identify ethical issue & problem
2) Identify & analyze alternatives
3) Select one alternative
4) Justify selection

67
Q

Bioethical Dilemmas

A

Abortion: Roe vs Wade, 1973
Death: Euthanasia & Assisted Suicide

68
Q

Principle of Paternalism

A

“father knows best”- Overlooks the patients’s right to autonomy in an attempt to act in the best interest of the patient

69
Q

Principle of Autonomy

A

Patient has right to know & make decisions about his/her health care

70
Q

Principles of Accountability

A

Nurses has ethical obligation to uphold the highest standards of practice & care

71
Q

Population Trends

A

African-Americans, Hispanics, American Indians: all growing fast- by 2025 should be about ~ 55% of population

72
Q

Poverty

A

Minority group: lack of health insurance
Poverty level: $15000/yr & goes up $4000 every person
Higher cost of healthcare-> coupled w/ low income-> prevented most minorities to seek tx- NO PREVENTATIVE care

73
Q

Cultural Competance

A

Deliver competent patient-centered care

Sensitive to other beliefs, learn about other beliefs, avoid negative behavior

74
Q

Value

A

Standard people use to assess themselves and others

75
Q

Belief

A

What is important and worthwhile to you (how you live your life)

76
Q

Cultural phenomena

A

environmental control, biological (genetic build), social organization (family), communication (verbal, silent, nonverbal, languages), space (personal space), time (orientation)

77
Q

Variations among cultural groups (TOUCH)

A

African Americans: touching another’s hair is considered offensive
Asians: Not customary to shake hands of opposite sex
Hispanics: Touching often is observed btwn 2 people in conversation
American Indians: Light touch of hand instead of firm handshake often used when greeting

78
Q

Variations among cultural group (VERBAL)

A

African Americans: Asking personal ??s when first meeting a person is offensive
Asians: High respect for others, especially those in positions of authority
Hispanics: Expression of negative feelings is considered impolite
American INdians: Speak in low tone & expect listener to be attentive

79
Q

Leadership

A

Anytime a person attempts to influence the beliefs, opions & behaviors of a person or group

80
Q

Leadership Theory

A

Traits: dependable, trustworthy, has followers, self-confident, aware of what is going on
2 different types: transformational & transactional

81
Q

Transformational Leader

A
  • Encourages to work toward a common goal (mentoring)
  • Admired & emulated
  • provides meaning to staff based on need
82
Q

Transactional Leader

A
  • Focus on day-to-day tasks
  • reward staff for desired work,
  • wait until problems occur then deal w them
83
Q

Patient satisfaction

A
  • Started from shortage
  • Post-quality & satisfaction
  • How quick call light was answered, warm blankets, more pillows, etc.
84
Q

Budgeting for Nurses

A
  • planning
  • communication
  • monitoring progress
  • evaluating performance
85
Q

3 types of budgeting

A
  • Operational (revenues & expenses for unit)
  • Labor budget (salary, PTO, wages)
  • Capital budget (construction, major equipment purchases)
86
Q

Incident Chart

A

Injury, death, malfunction of equipment, adverse reactions, inabilty to meet patient’s needs, lack of staff, unresolved problems, unethical, illegal or incompetent practice, patient complaint about provider, toxic spills, violent behavior

87
Q

Social Security Act 1935

A

Financial help to people so they can afford healthcare (older adults)

88
Q

Hill-Burton Act (1946)

A
  • Largest commitment of federal dollars to healthcare

- Provide funding to construct hospitals & health0care facilities based on needs

89
Q

Nursing in the 1970s

A
  • Master’s level preparation
  • Permit minority nurses to earn PhD
  • ANA convention in Atlantic City (1976)
90
Q

Nursing in the 1960s

A
  • Medicare—> 65 or older, disabled, dialysis

- Medicaid–> low income

91
Q

Nursing in the 1980s

A
  • DRG reimbursement system (diagnosis related group)
  • Decrease healthcare costs
  • Increase outpatient services
  • Decrease in hospital staff (decrease in nursing enrollment)
92
Q

Nursing in the 1990s

A
  • More women w families entered workforce
  • 10-12 hr shifts
  • Universal precautions—AIDS epidemic
93
Q

Nursing in the 21st Century

A
  • Issues of acces, cost, quality, safety & accountability
  • IOM: est. 2 yr initative on the future of nursing (higher educated nurse- BSNs)
  • Affordable Care Act: expected to provide insurance coverage for 32 million uninsured Americans

Professional Role (1 decks)

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