Key learning areas Flashcards
(142 cards)
1
Q
What is ISBAR?
A
A communication/handover tool
2
Q
What professional standards guide our practice?
A
> Code of conduct for Nurses in Australia
The International Council of Nurses Code of Ethics for Nurses
National Competency Standards for the Registered nurse
Social Media Policy
Professional Boundaries
3
Q
What are the principals of safe practice in manual handling?
A
> Bending knees
Raising the bed
Do not bend your back
Use machinery/aids like a hoist and the slide sheet
4
Q
What different perspectives of comfort exist?
A
> Physical
Psychospiritual
Environmental
Social
5
Q
What nursing interventions promote comfort?
A
> Physical comfort:
fluid and electrolyte balance, oxygenation, thermoregulation, analgesia, restoration of homeostasis.
> Psychospiritual:
comfort, massage, therapeutic touch, visitors, encouragement, motivation.
> Sociocultural:
cultural sensitivity, reassurance, support, positive body language, caring.
> Environmental:
orderliness, quiet, comfortable furniture, free from odours, safe.
6
Q
What is the definition of nursing?
A
The International Council of Nurses defines nursing as “encompassing autonomous and collaborative care of individuals of all ages, families, groups and communities, sick or well and in all settings. Nursing includes the promotion of health, prevention of illness and the care of ill, disabled and dying people. Advocacy, promotion of a safe environment, research, participation in shaping health policy and in patient and health systems management, and education are also key roles.”
7
Q
What are the frameworks for nursing practice?
A
> AHPRA Code of Conduct
>Nursing and Midwifery Board Code of Ethics
8
Q
What legal and ethical principals apply to nursing?
A
>Confidentiality >Privacy >Consent >Documentation >Respect
9
Q
What is the importance of effective communication?
A
> Establishes good rapport with patients and their families (leads to honesty)
Improved patient satisfaction
Makes the nurse a better advocate
Improved patient outcomes
Improved morale and job satisfaction for nurses
10
Q
What are some tools we can use to assess our patients?
A
>Documents >Sphygmomanometer >Thermometer >Pulse oximeter >ECG
11
Q
What is ISBAR made up of?
A
I - identify who you are and what your role is. Identify the patient.
S - situation - what is going on?
B - background - clinical background/context.
A - assessment - what do you think the problem is?
R - recommendations - what would you reccommend.
12
Q
What is evidence based practice?
A
Integrating individual clinical expertise with the best available external clinical evidence from systematic research.
ie. The information/care you give a patient is based off of sound research not just opinion.
13
Q
How do we use evidence based research in practice?
A
Evidence based research guides practice by regulating the way people are treated by giving proper evidence as to what works and what doesn’t.
If care isn’t backed by evidence, the carer is liable.
14
Q
How do we use evidence based research in practice?
A
Evidence based research guides practice by regulating the way people are treated by giving proper evidence as to what works and what doesn’t.
If care isn’t backed by evidence, the carer is liable.
15
Q
Where did nursing start?
A
> Nursing started out with Sisters
>Florence nightingale is considered the first “real” nurse and the pioneer of infection control
16
Q
What are some beneficial and non-beneficial nursing stereotypes?
A
Beneficial:
>Able to be trusted
>Kind
Non-beneficial:
>Less educated than other health professions
>All girls
17
Q
What are HAIs?
A
An infection that develops as a result of healthcare that the patient was not suffering from before admission.
18
Q
What is infection control?
A
The discipline concerned with preventing HAIs.
19
Q
What are the different modes of infection transmission?
A
> Contact - direct or indirect contact with contaminated blood, water, food or vectors.
> Airborne - small particle aerosols and dust.
> Droplet - coughing and sneezing.
20
Q
What is workplace health and safety?
A
The protection of the health and safety of all stakeholders in the workplace from exposure to hazards and risks resulting from work activities.
21
Q
What are some responsibilities that the hospital has with regards to workplace health and safety?
A
> Protect the health, safety and welfare of employees and others who may be affected by their business.
An employer has a duty of care to its staff.
22
Q
What are some responsibilities the nurse has with regards to workplace health and safety?
A
> Comply with workplace policies.
Comply with safe work practices.
Use appropriate equipment.
Report hazards, faulty equipment or injury.
Perform day to day care of equipment provided for manual handling.
Participate in training.
23
Q
What is the Framework for Practice Thinking?
A
A model of clinical reasoning.
24
Q
When do we use a slidesheet?
A
When you’re transferring a patient without the need ti life them.
eg. Transferring a patient from one bed to another
25
How do we make a care plan?
Column 1 - Assessment
Column 2 - Goals (long and short term)
Column 3 - Action plan for the implementation of interventions
Column 4 - Scientific rationale for specific intervention
Column 5 - Expected outcomes/evaluation
26
What is leadership in nursing?
In nursing, we looks for transformational leaders.
There are 4 elements of a transformational leader:
1. Vision
2. Communication
3. Trust
4. Self-knowledge
In the nurse-leadership model, success is measured through:
1. Organisational structure
2. Recruitment retention
3. Cost and productivity
4. Improved patient outcomes
27
Why do we promote comfort for our patients and what forms of comfort exist?
Nursing and comfort have a very important relationship.
Comfort exists in 3 forms:
1. Relief - experienced when specific measures of comfort care are met.
2. Ease - experienced if the patient is in a comfortable state of contentment.
3. Transcendence - the state of comfort in which patients are able to rise above their challenges and look at everything in a controlled and calm way.
28
How do we promote patient safety?
>Providing a safe environment - temperature, food, physical hazards and infection control.
>identifying and minimising potential risks - falls injury & equipment faults.
29
What do we know about professional development in nursing?
Continuing professional development (CPD) is how nurses and midwives maintain, improve and broaden their knowledge, expertise and competence, and develop the personal and professional qualities required throughout their professional lives.
Continuing professional development is a part of the Nursing Registration Standards set out by the NBMA which requires a minimum of 20 hours of professional development per registration period.
30
What are some exmaples of standard precaustion?
```
>Hand hygiene
>PPE
>Safe use and disposal of sharps
>Routine environmental cleaning
>Reprocessing reusable medical equipment
>Antiseptic non-touch technique
>Waste management
>Appropriate handling of laundry
>Cough etiquette
```
31
What are standard precautions?
Work practices that apply to everyone regardless of perceived or confirmed infection status.
32
What are some examples of standard precautions?
```
>Hand hygiene
>PPE
>Safe use and disposal of sharps
>Routine environmental cleaning
>Reprocessing reusable medical equipment
>Antiseptic non-touch technique
>Waste management
>Appropriate handling of laundry
>Cough etiquette
```
33
How do we collate data?
We collate data according to Gordon's 11 Functional Health Patterns:
1. Health perception/health management
2. Nutritional-metabolic
3. Elimination
4. Activity-exercise
5. Cognitive-perceptual
6. Sleep-rest
7. Self perception/self concept
8. Risk-relationship
9. Sexuality-reproductive
10. Coping/ stress tolerance
11. Value-belief
34
Why do we need documentation?
>Nursing documentation is essential for good clinical communication.
>Provides an accurate reflection of nursing assessments, changes in clinical state, care provided and important patient information to support the multidisciplinary team.
35
Why do we need documentation?
>Nursing documentation is essential for good clinical communication.
>Provides an accurate reflection of nursing assessments, changes in clinical state, care provided and important patient information to support the multidisciplinary team.
>If there are ever any adverse affects of care, documentation is all you have other than your memory to defend yourself.
36
How do we collect data?
We collect data according to Gordon's 11 Functional Health Patterns:
1. Health perception/health management
2. Nutritional-metabolic
3. Elimination
4. Activity-exercise
5. Cognitive-perceptual
6. Sleep-rest
7. Self perception/self concept
8. Risk-relationship
9. Sexuality-reproductive
10. Coping/ stress tolerance
11. Value-belief
37
What are the types of knowledge?
There are 4 types of knowledge:
1. Empirical - knowledge from external sources that can be verified through experience.
2. Personal -knowledge and attitudes verified from self-understanding/knowing yourself.
3. Ethical - attitudes and knowledge derived from an ethical framework.
4. Aesthetic - knowledge derived from an appreciation of the nature and art of nursing (creation of appreciation of the situation/imagining yourself in the patient's situation).
38
How do we gain knowledge?
```
>Observing
>Personal experience
>Trial and error
>Intuition (gut feeling)
>Reasoning
>Research
```
39
How do you find the best available evidence (hierarchy of evidence)?
1. Systematic review/meta analysis of all relevant randomised controlled trials.
2. Evidence based clinical practice guidelines based on systematic reviews of randomised controlled trials.
3. Evidence obtained from at least once well designed randomised controlled trial.
4. Evidence obtained from controlled trials and case control and cohort studies.
5. Evidence from systematic reviews of descriptive and qualitative studies.
6. Evidence from one single descriptive and qualitative study.
7. Evidence from opinion of authorities/reports of expert committees.
40
What barriers to infectious agents exist?
The innate and adaptive immune system.
41
What are the principals of infection control?
```
Principals of infection control include:
>Standard precautions
>Contact precautions (transmission)
>Droplet precautions (transmission)
>Airborne precautions (transmission)
```
42
When do we use PPE?
When there may be contact with blood, bodily fluids or respiratory secretions.
43
When do we use PPE?
When there may be contact with blood, bodily fluids or respiratory secretions.
44
In what order to we don PPE?
1. Wash hands or use alcohol-based rub
2. Gown
3. Mask
4. Goggles
5. Gloves
45
In what order do we remove PPE?
1. Gloves
2. Hand hygiene
3. Goggles
4. Gown
5. Mask
6. Hand hygiene
46
How do we manage waste in nursing?
> Anatomical waste and clinical waste goes into the yellow bin.
> Cytotoxic waste goes in a purple bin.
> Pharmaceutical waste goes in the red bin
>Radioactive waste goes in the red bin with the radiation symbol.
47
How should we dispose of sharps?
All sharps need to be disposed of in specified sharps containers.
Do not overfill the containers as they may put pressure on the lid, causing it to burst and prick someone.
48
What is a care plan?
A nursing care plan provides direction on the type of nursing care the individual/family/community may need.
49
Why do we need to develop a care plan?
>Care plans provide direction for individualised care of the client.
>Continuity of care. The care plan is a means of communicating and organising the actions of a constantly changing nursing staff
50
How do we cluster data?
We cluster (organise) data into groups that lead us to identify potential or actual health problems and then arrange them in a way that focuses the attention on the patient functions needing support and assistance for recovery.
51
What is an actual problem?
Signs or symptoms occurring as a result of a diagnosis.
52
What is a potential problem?
There are no signs or symptoms because the problem hasn't occurred yet.
53
Who regulates nursing in Australia?
The Nursing and Midwifery Board of Australia (NMBA) regulates nurses and midwives under the Health Practitioner Regulation National Law (2009) – this is statutory regulation.
54
Why do we need to adhere to confidentiality, respect and privacy?
Confidentiality and privacy are not only ethical principals of nursing but are also legal responsibilities.
By being respectful, we are able to build rapport with patients and promote a range of improved outcomes.
55
What are the main points of the Code of Ethics?
The NBMACode of Ethics consists of 5 fundamental responsibilities:
1. To promote health
2. To prevent illness
3. To restore health & alleviate suffering
4. Nurses render health services to the individual, the family & the community and coordinate their services with those of related groups.
5. Respect for human rights including cultural rights, the right to life and choice, to dignity and to be treated with respect.
56
What are some main points covered in the Code of Conduct?
The AHPRA Code of Conduct has 7 values:
1. Nurses respect & adhere to professional obligations under national law & abide by relevant laws.
2. Nurses provide safe, person-centred evidence-based practice for the health and wellbeing of people and in partnership with the person, promote shared decision making & care delivery between the person, their partners, family, friends and health professionals.
3. Nurses engage with people as individuals in culturally safe and respectful ways, foster open, honest and compassionate professional relationships & adhere to their obligations about privacy & confidentiality.
4. Nurses embody integrity, honesty, respect and compassion.
5. Nurses commit to teaching, supervising and assessing students and other nurses in order to develop the nursing workforce across all contexts of practice.
6. Nurses recognise the vital role of research to inform quality healthcare & policy development, conduct of research ethically & support the decision making of people who participate in research.
7. Nurses promote health & wellbeing for people & their families, colleagues, the broader community & themselves & in a way that addresses health inequality.
57
What is meant by the term "comfort"?
The satisfaction (actively, passively or cooperatively) of the basic human needs for relief, ease or transcendence arising from health care situations that are stressful.
58
Is there a relationship between comfort and the core concept of nursing? What is it?
Nursing and comfort have a very important relationships:
>Nurses play an important role in assessing, promoting and maintaining comfort of their patients. This is not a one off event and requires the nurse to reassess the effects of any measure that is implemented to promote comfort.
59
How do we know that comfort has been obtained?
Comfort exists in 3 forms:
1. Relief - if specific measures of patient care are met, the patient experiences comfort in the relief sense.
2. Ease from feeling discontent. If the patient is in a comfortable state of contentment, they are experiencing comfort in the ease sense.
3. Transcendence - the state of comfort in which patients are able to rise above their challenges and look at everything in a controlled and calm way.
60
What are the 5 moments of hand hygiene?
```
>Before touching a patient,
>Before clean/aseptic procedures,
>After body fluid exposure/risk,
>After touching a patient, and.
>After touching patient surroundings.
```
61
Why do we do hand hygiene?
To prevent to transmission of infection including HAIs.
62
Why do we try to avoid HAIs?
We try to avoid HAIs because they result in:
```
>Increased hospital stays
>Decreased quality of life
>Burden on the healthcare system
>Death
>Additional costs
>Reduced income
>Risk of potential spread of infection
```
63
What is infection control?
Infection control is the discipline concerned with preventing infection.
64
What is manual handling?
Any transporting or supporting of a load (including the lifting, putting down, pushing, pulling, carrying or moving thereof) by hand or bodily force. The load can be an object, person or animal.
65
What are the different types of positioning?
>Supine - flat on the back
>Prone - face down
>Semi Fowler's - sitting up at a 45 degree angle
>Right lateral recumbent - laying on the right side
>Left lateral recumbent - laying on the left side
>Sims Prone - face down with a leg bent
66
Why is it important for us to adhere to infection control processes?
>Nurses are the healthcare professionals who have the most consistent day-to-day contact with patients, it is crucial that they adhere to standard infection control and transmission-based precautions to prevent further spread of HAIs.
>It is part of our duty to ensure no harm comes to patients.
>National and state policy states that we need to follow infection control processes.
67
When do we make a closed bed and when do we make an open bed?
Closed bed - used when preparing for a new admission.
Open bed - used for surgical recovery/post operative patients to make it easier for them to get in bed.
68
How do we do risk assessment for pressure areas/what tests do we use?
>Waterlow score - estimates the risk of a patient developing a pressure sore by assessing activity, incontinence, skin type, weight and special risks. The higher the score, the higher the risk.
>Braden scale - assesses sensory perception, moisture, activity, mobility, nutrition and friction and sheer. The lower the score, the higher the risk.
>Norton scale - assesses physical condition, mental condition, activity, mobility and incontinence. The lower the score, the higher the risk.
>Skin assessment - inspects skin integrity, temperature, colour, moisture level and turgor.
>Pain assessment - patients who lack sensation are at a greater risk of developing pressure injury.
69
Why do we need to manage and prevent pressure injuries?
>95% of all pressure injuries are preventable.
>Prevention is an essential part of nursing care.
>Pressure injury decreases quality of life.
>Increases length of hospital stay.
>Are an indicator of poor quality care.
>Has a financial impact on patients, carers and their families.
>Places a burden on the healthcare system and the health budget.
70
What are pressure injuries?
```
An injury the the skin &/or the underlying tissue, usually over a bony prominence. they are also known as:
>Pressure ulcer
>Pressure sore
>Decubitus ulcers
>Bed sores
```
71
How do we classify the stages of pressure injuries?
Stage 1/non-blanchable erythemia - a defined area of redness that won't blanch.
Stage 2/partial thickness - an intact or ruptured blister with a red or pink wound bed.
Stage 3/full thickness - subcutaneous fat may be visible.
Stage 4/full thickness - full thickness tissue loss with bone, tendon and muscle exposed.
72
How do pressure injuries occur?
PIs occur as a result of:
>Shearing - sliding or dragging.
>Friction - abrasion of the surface of the skin by rubbing against a surface.
73
How do we prevent pressure injuries?
Surface prevention - foam mattress, air mattress.
Mobile prevention - reposition patients 2nd hourly, or educate them to shift their weight every 15 minutes. commence a repositioning chart.
Incontinence and moisture prevention - make sure skin is clean and dry, use emollient moisturisers and provide regular incontinence aid.
Nutrition and hydration prevention - refer the patient to a dietician and consider oral nutrition supplements if necessary. Monitor for signs of dehydration/ensure the patients is adequately hydrated.
74
How do we manage pressure injuries?
>Conduct a wound assessment.
>Promote wound healing.
>Control any infection and prevent the spread of infection.
>Provide pain management.
75
What is telehealth?
Telehealth is the secure transmission of images, voice and data between 2 or more units via telecommunication channels to provide clinical advice, consultation, monitoring, education and training and administrative services.
76
What is mobile health?
Mobile health is the use of technology like mobiles, smart watches etc. to provide healthcare support, delivery and intervention.
77
Why are we bound by legal and ethical contriants?
Nurses who do not follow the nursing code of ethics could also find themselves in legal trouble. They can also find themselves in legal trouble if they don't follow the law.
These laws and ethical constraints are there to protect patients, their families and other staff from any sort of harm. Should a nurse not follow them and someone ends of hurt, they are legally responsible in a court of law.
78
Why are we bound by codes and standards?
To presence the image of nurses. Nursing is seen as the most trusted profession by the public, without codes and standards to guide our delivery of care, the standard of care would drop, thus resulting in nurses becoming less trusted in the eyes of consumers.
79
What are the methods we use to try and prevent the transmission of infection?
>Hand hygiene
>PPE
>Aseptic technique
>Controlling the environment
80
Why do we identify actual and potential problems in care plans?
We identify actual problems so that we can find a way to manage them.
We identify potential health problems to stop them from occurring at all, reducing complications and therefore, the length of an individual's hospital stay.
81
How do we evaluate our nursing interventions?
We evaluate nursing interventions by measuring to what degree our goals have been achieved.
This is done to determine whether to continue, modify or terminate the plan or care.
82
What is therapeutic communication?
Therapeutic communication is an interaction between a nurse and a patient that helps advance the physical and emotional health of the patient.
Therapeutic communication relies on two types of communication:
1. Verbal - active listening, body posture, using seating appropriately & eye contact.
2. Nonverbal - low voice, even tone, acknowledge distress, present options & use present tense.
83
Why is telehealth and mobile health becoming more widely used?
The use of telehealth and mobile health are going to increase in the future with COVID being a major trigger.
```
They can:
>Serve people in rural and remote areas.
>Be cost effective.
>Be convenient
>Effectively manage chronic disease
```
84
What are the benefits of therapeutic communication?
>It enhances the patient's comfort levels, encourages a feeling of safety, and increases their trust in the nurse.
>It helps the nurse establish rapport with the patient, understand where the patient is coming from, exchange valuable information, and come up with individualised health-care intervention strategies that benefit the patient.
>A nurse who practices effective therapeutic communication also benefits from the knowledge that they helped someone in need as a result.
85
How has evidence based practice influenced nursing care?
>Turning patients every two hours is no longer a standard of care. The timing for turning patients should be dependent upon their condition and their risk for skin breakdown. For example, one patient may need to be turned every 15 minutes and another patient may need to be turned every hour.
86
Identify 6 requirements of nursing documentation and discuss why each component is important.
1. Factual information - provides legal evidence of the processes and outcomes of care.
2. Accurate and reliable - provides legal evidence of the processes and outcomes of care.
3. Complete details - ensures continuity and quality of care through communication.
4. Brief and concise - easy to understand.
5. Timely and current - gives and idea as of the efficiency and effectiveness of care.
6. Logical organisation of material - easy to understand/promotes continuity of care.
87
Define infection.
A disease state that results from the presence of pathogens in or on the body.
88
Define pathogen.
A disease producing microorganism.
89
What is a latrogenic infection?
Infections that occur as a result of healthcare interventions.
90
Define colonisation.
Sustained presence of replicating infectious agents on or in the body, without the production of an immune response.
91
What/who might organisms transfer to?
>Other patients
>Healthcare workers
>Objects - furniture and equipments
>Their environment - bathrooms
92
How might microorganisms enter the body?
>Through broken skin
>Mucous
>Sharps injury contaminated with disease causing agent.
93
What might make someone a susceptible host to infection?
```
>Age
>Nutritional status
>Stress
>Hereditary conditions
>Disease process
>Medical treatments/therapies
>Presence of invasive devices
```
94
What are the 4 stages of infectious disease?
1. Incubation period - interval between a pathogen entering the body and the appearance of symptoms.
2. Prodromal stage - onset of non-specific symptoms.
3. Illness stage - when you manifest specific symptoms.
4. Convalescence - when the acute symptoms of infection disappears.
95
What are transmission based precautions?
Additional practices we use when standard precautions alone may not be enough to prevent transmission.
>Often used in an outbreak - gastro
>Tailored to the specific infectious agent and it's mode of transmission.
96
What is included in contact precautions?
>Hand hygiene
>Gown/apron
>Gloves
97
What is included in droplet precautions?
>Hand hygiene
| >Mask
98
What is included in airborne precautions?
>Hand hygiene
| >N95 or N2 mask (fit check the mask)
99
What responsibilities do nurses have in terms of infection control?
>Follow specific infection prevention and control policies as part of your contact of employment.
>Follow policies regarding standard and transmission based precautions.
>Report and unknown or potential exposures to blood and bloody substances.
>Bw aware of immunisation requirements against infectious diseases & keep personal immunisation records.
>Know your infectious status with regard to blood borne viruses.
>Seek advise and appropriate medical care if you have an infection.
100
What responsibilities to patients have in terms of infection control?
>Patients have an ethical responsibility to declare their infectious status to those associated with their treatment however, no legal requirement.
>Understand and acknowledge their responsibility with regard to infection control.
101
What is a hazard?
Something with the potential to cause injury or disease, damage to property or disease.
102
What is a risk?
To potential for harm from exposure to a hazard.
103
What are some hazards nurse may encounter?
```
>Manual handling
>Violence and sexual harassment
>Poor ergonomics
>Increased emotional, social, physical and spiritual demands
>Impacts of shift work
>Inadequate allocation of resources
>Working in isolation
>Exposure to blood and bodily fluids.
```
104
What are some WH&S legislation that might affect nurses?
>Work, Health and Safety Act, 2011 No. 10
>NSW Work, Health and Safety Regulation, 2017
>Specific organisational guidelines.
105
What consequences might stem from failure to comply with WH&S Protocol?
>Prosecution
>Improvement/infringement notices.
106
What are the main points of the AHPRA Social Media Policy?
>Complying with confidentiality & privacy obligations.
>Complying with professional obligations as defined by your board's Code of Conduct.
>Maintaining professional boundaries - don't add your patient on facebook.
>Communicate professionally and respectfully with patients, colleagues and employers.
>Don't present information that is false, misleading or deceptive.
107
What things constitute for notifiable conduct in Australia as stated by the Health Practitioner Regulation National Law Act (2009)?
>Practitioner is intoxicated by alcohol or drugs.
>Engaged in sexual misconduct in connection with the practice of their profession.
>Placed the public at risk or harm because the practitioner has an impairment.
>Placed the public at risk of harm because the practitioner has practiced the profession in ways that constitute a significant departure from accepted standards.
108
Can patient rights be described as a subcategory of human rights?
Yes.
109
What rules guide the sharing of patient information?
>Only divulge patient information on a need-to-know basis.
>It is a breach of privacy to access you own medical records.
>Patient medical records are confidential documents.
>Do not have conversations about a patient in public/where you can be overheard.
>Limit the sharing of patient information over the phone.
110
What is criminal law?
A set of rules about how you should act within and treat society that sanction punishment if not followed.
If you have violated these laws, you have violated society in some way.
111
What is civil law?
Nothing to do with police or punishment. It aims to solve disputes between people. It usually results in compensation for damages.
Civil law is seen more commonly in nursing.
112
What are the legal principals of professional negligence?
1. The defendant owed a duty of care the the plaintiff.
2. The defendant was in breach of this duty of care by failing the standard expected.
3. The plaintiff suffered damage and loss as a result of the negligent act.
4. The damage and loss was a reasonably foreseeable consequence of the negligent act.
113
What sources of evidence might be used in civil law for nurses?
```
>Policies
>Guidelines
>Directives
>Standards for practice
>Clinical notes/patient records
>Academic publications - what does research say we should've done?
```
114
What are the 3 forms of consent?
>Written
>Implied
>Verbal
115
What are the 3 components of valid consent?
>Freely given
>Informed
>The person giving consent has the legal capacity to give it - right age (14) and cognitively sound.
116
Define mobility
A person's ability to move about freely.
117
Define immobility
The inability to move around freely.
118
What are some physical effects of immobility?
>Metabolic - decreased appetite resulting in weight loss and atrophy
>Musculoskeletal - atrophy, impaired calcium metabolism resulting in joint contracture
>Urinary - the kidneys and ureters are level and urine remains in the pelvis longer in a process called urinary stasis.
>Integumentary - pressure sores and skin shearing
>Cardiovascular - increased cardiac workload, orthostatic hypotension (when the person rises) and DVT
>Respiratory - increased respiratory effort, hypostatic pneumonia and atelectasis (alveolar collapse)
119
What reasons might there be for impaired mobility?
>Health status/acute illness
>Prescribed restriction - bed rest
>A result of external devices - cast
>Impaired motor function
>Voluntary restriction - pain
120
How do we assess mobility?
Assessment of mobility is part of the head to toe assessment which includes the assessment of:
>Gait
>Range of motion
>Activity tolerance
121
When should we change the linen on a bed?
If the patient is:
>Diaphoretic
>Has a draining wound
>Is incontinent
122
How can we assess a patient's comfort?
>Pain assessment
>Oral assessment
>Pressure ulcer scale
>Quality of. life tools
123
What are some common sites for pressure injuries?
```
>Sacrum
>Heels
>Elbows
>Ankles
>Knees
>Shoulder blades
>Back of head
```
124
What are some risk factors for the development of pressure injuries?
```
>Immobility
>Paralysis
>Dementia/cognitive dysfunction
>Stroke/hemorrhage
>Malnutrition
>Impaired sensation including diabetes
```
125
What are the 5 C's of caring?
1. Commitment
2. Conscience
3. Competence
4. Compassion
5. Confidence
126
What stages are included in the Framework for Practice Thinking?
1. What is going on here? - assessment phase
2. What does this mean? - interpret data and identify the health problem
3. What can be done? - plan care
4. What should be done? - establish priorities and set goals
5. What is done? - the care intervention
5. So what?
127
What are the stages of the Clinical Reasoning Cycle?
1. Consider the patient situation
2. Collect cues/information
3. Process information
4. Identify problems/issues
5. Establish goals
6. Take action
7. Evaluate outcomes
8. Reflect on processes and new learning
128
What are the 5 rights of clinical reasoning>
1. The ability to collect the right cues
2. Take the right action
3. For the right patient
4. At the right time
5. For the right reason
129
What are the stages of SOAPIE?
S - situation
O - observation
A - assessment
P - problem
I - intervention
E - evaluation
130
Define documentation
Anything written or printed that is used to furnish evidence or information that is legal or ethical.
131
Define essential care
All aspects of care that are fundamental to patients and staff wellbeing.
132
What is meant by essentials of care?
Essentials of care is a framework that aims to provide person centred care in a way that is safe, dignified and compassionate.
133
What are the essential elements of nursing?
```
>Knowledge
>Patient centred
>Holistic
>Assessment, problem solving, communication skills, planning and nursing interventions
>Therapeutic interactions
>Reflective practice
```
134
When might nurses need to use de-escalation skills?
```
In moments of:
>Distress
>Anger
>Aggression (verbal, physical or passive)
>Criminality
>Disorientation
```
135
What might trigger distress in a person?
```
>Frustration
>Fear
>Manipulation
>Intimidation
>Mental state
```
136
What are the most common causes of death in Australia?
```
> CHD
>Dementia
>CVD
>COPD
>Cancer
```
137
What are some risk factors for death?
>Lifestyle factors - tobacco use, diet
>Occupational exposure to chemicals - asbestos
>Biological - high rates of x-ray exposure
>Genetic defects - mutation in the gene.
138
What are come common needs for people living with life limiting illness?
>Management of physical symptoms - pain, breathlessness and fatigue
>Management of psychological symptoms - depression and anxiety
>Need for social support
>Culturally specific needs
>Spiritual and existential concerns
>Information and communication
139
How do we have a discussion about death (PREPARED)?
P - prepare for the discussion (collect all information)
R - relate to the person
E - elicit patient and caregiver preferences
P - provide appropriate information
A - acknowledge emotions and concerns
R - realistic hope
E - encourage questions
D - document
140
What might be some barriers to having a conversation about death?
>Lack of training
>Lack of time
>Stress
>Fear of upsetting the patient and their family
>Hopelessness regarding the unavailability of alternate treatments
141
What is palliative care?
WHO definition:
An approach that improves the quality of life of patients and their families facing problems associated with life threatening illness through the prevention of suffering by early identification and impeccable treatment of pain and other problems, physical, psychological and spiritual.
142
What acronym do we use to manage risk?
IAEC!
I - Identify hazard (eg. a puddle of water)
A - Assess to determine risk (what is the likelihood that someone might step in it and have a fall?)
E - Eliminate risk (call a cleaner, mop it up, put up a sign)
C - Control strategies (what caused it in the first place? Get it followed up on so we can eliminate the hazard for good)
