Note cards from Week 2 reading

Question 1

evidence- based practice (EBP)

Answer 1

evidence based nursing, occurs when the nurse can “integrate best current evidence with clinical expertise and patient/family preferences and values for delivery of optimal health care” pg 26

Question 2

what goes into EBP?

Answer 2

Best evidence + clinical expertise + patient values and preferences = EBP

Question 3

research

Answer 3

entails using formal and systematic processes to address problems and answer questions.

Question 4

cultivating a spirit of inquiry

Answer 4

nurses need to be curious and willing to investigate how various practices compare and which might be best for a specific client.

Question 5

ask clinical questions

Answer 5

for consistency and efficiency, nurses should state the question in a standard format such as PICOT

Question 6

search for the best evidence

Answer 6

in the previous step, key terms are identified that facilitate identifying relevant evidence in the literature

Question 7

critically appraise the evidence

Answer 7

several toolkits or schema are available to assist the nurse in determining the most valid, reliable, and applicable evidence. in some cases, relevant studies may already have been synthesized.

Question 8

integrate the evidence with clinical expertise and client/family preferences and values

Answer 8

evidence must not be automatically applied to the care of individual clients. each nurse must determine how the evidence fits with the clinical condition of the client, available resources, institutional policies, and the client’s wishes.

Question 9

implement and evaluate the outcomes of the intervention

Answer 9

the nurse gathers all relevant data that may indicate whether or not the intervention was successful

Question 10

value system

Answer 10

people organize their values internally along a continuum from most important to least important

Question 11

beliefs (opinions)

Answer 11

are interpretation or conclusions that people accept as true. based on more faith than fact
may only last briefly

Question 12

attitudes

Answer 12

mental positions or feelings towards a person, object, or idea. lasts over time.

Question 13

values

Answer 13

enduring beliefs or attitudes about the worth of a person, object, idea, or action.
pg 73

Question 14

essential nursing values: altruism

Answer 14

a concern for the welfare and well-being of others.

Question 15

essential nursing values: autonomy

Answer 15

the right to self-determination. when the nurse respects patient’s rights to make decisions

Question 16

essential nursing values: human dignity

Answer 16

respect for the inherent worth and uniqueness of individuals and populations.

Question 17

essential nursing values: integrity

Answer 17

acting in accordance with an appropriate code of ethics and accepted standards of practice.

Question 18

essential nursing values: social justice

Answer 18

acting in accordance with fair treatment regardless of economic status, race, ethnicity, race, sexual orientation, etc.

Question 19

professional values

Answer 19

are acquired during socialization into nursing from codes of ethics, nursing experiences, teachers, and peers.

Question 20

values clarification

Answer 20

a process by which people identify, examine, and develop their own individual values.

Question 21

bioethics

Answer 21

ethics as applied to human life or health

Question 22

nursing ethics

Answer 22

refers to ethical issue’s that occur in nursing practice

Question 23

morality

Answer 23

usually refers to private, personal standards of what is right and wrong in conduct, character, and attitude.

Question 24

ethics

Answer 24

a method of inquiry that helps people to understand the morality of human behavior, the practices or beliefs of a certain group, and the expected standards of moral behavior of a particular group as described in the groups formal code of professional ethics.

Question 25

moral development

Answer 25

the process of learning to tell the difference between right and wrong and of learning what ought and ought not to be done.

Question 26

principles based (deontological) theories

Answer 26

involve logical and formal processes and emphasize individual rights, duties, and obligations

Question 27

utilitarianism

Answer 27

one form of consequentialist theory, views a good act as one that is the most useful- that is, one that brings the most good and the least harm to the greatest number of people. this is called the principle of utility.

Question 28

relationship based caring theories

Answer 28

stress courage, generosity, commitment, and the need to nurture and maintain relationships.

Question 29

consequence based teleological theories

Answer 29

look to the outcomes (consequences) of an action in judging whether that action is right or wrong.

Question 30

moral rules

Answer 30

specific prescriptions for actions

Question 31

autonomy

Answer 31

refers to the right to make one's own decisions.

Question 32

nonmaleficence

Answer 32

the duty to "do no harm"

Question 33

beneficience

Answer 33

means doing good.

Question 34

justice

Answer 34

frequently referred to as fairness

Question 35

fidelity

Answer 35

means to be faithful to agreements and promises

Question 36

veracity

Answer 36

refers to telling the truth

Question 37

accountability

Answer 37

answerable to onself and others for ones own actions

Question 38

responsibility

Answer 38

refers to the specific accountability or liability associated with the performance of duties of a particular role.

Question 39

code of ethics

Answer 39

a formal statement of a groups ideals and values

Question 40

read application of a bioethical decision- making model

Answer 40

page 81-82

Question 41

active euthanasia

Answer 41

involves actions to bring about the clients death directly, with or without client consent

Question 42

assisted suicide

Answer 42

giving clients the means to kill themselves if they request it

Question 43

passive euthanasia

Answer 43

commonly referred to now as withdrawing or with-holding life sustaining therapy, involves the withdrawal of extraordinary means of life support such as removing a ventilator or withholding special attempts to revive a client.

Question 44

advocate

Answer 44

one who expresses and defends the cause of another

Question 45

health care system

Answer 45

the totality of service offered by all health disciplines

Question 46

primary prevention:

Answer 46

health promotion and illness prevention

Question 47

secondary prevention

Answer 47

diagnosis and treatment

Question 48

tertiary prevention

Answer 48

rehabilitation, health restoration, and palliative care

Question 49

types of health care agencies examples

Answer 49

``` public health- health departments physicians offices ambulatory care centers- occupational health clinics hospitals subacute care facilities- generally the individuals condition doesn't require high monitoring extended (long term) care facilities retirement and assisted living centers rehab centers home health care agencies day care centers- for adults and children who can't be left alone rural care hospice services crisis centers mutual support and self help groups ```

Question 50

safety- net hospitals

Answer 50

provide a significant level of care to low-income, uninsured, and vulnerable populations.

Question 51

examples of providers of health care

Answer 51

nurse, case manager, dentist, emergency medical personnel, any therapist, pharmacist, social worker

Question 52

licensed vocational nurse or licensed practical nurse

Answer 52

provides direct client care under the direction of an RN, physician, or other licensed practitioner.

Question 53

factors affecting health care delivery

Answer 53

``` increasing # of older adults advances in technology economics women's health uneven distribution of services access to health insurance homeless and the poor health insurance portability and accountability act demographic changes ```

Question 54

factors contributing to the health problems of the homeless and the poor

Answer 54

- poor physical environment - inadequate rest and privacy - improper nutrition - poor access to facilities for personal hygiene - exposure to the elements - lack of social support - few personal resources - questionable personal safety - inconsistent health care - difficulty with adherence to treatment plan

Question 55

intent of HIPAA regulation

Answer 55

- provides individuals with more control over their health info - establishes limits for appropriate use and release of health care info - requires health care providers and their agent to comply with safeguards to protect individual privacy related to health care info - delineates a set of civil and criminal penalties holding HIPAA regulation transgressors accountable for actions if a client's health care privacy is violated

Question 56

case management

Answer 56

describes a range of models for integrating health care services for individuals or groups. - assessing clients and their homes and communities - coordinating and planning cost-effective client care - collaborating with other health professionals - monitoring client's progress - evaluating client outcomes

Question 57

critical pathway

Answer 57

a plan or tool that specifies inter-professional assessments, interventions, treatments, and outcomes for health-related conditions across a timeline

Question 58

team nursing

Answer 58

the delivery of nursing care to individual clients by a group of providers led by a professional nurse.

Question 59

Payment sources

Answer 59

``` medicare and Medicaid supplemental security income children's health insurance program women, infant, and children program prospective payment system private insurance group plans ```

Question 60

medicare

Answer 60

for 65 years of age and older

Question 61

medicaid

Answer 61

for people who require financial assistance, low income

Question 62

coinsurance

Answer 62

the percentage share of a government approved charge that is paid by the client; the remaining percent is paid by the plan.

Question 63

supplemental security income (SSI) benefits

Answer 63

people with disabilities or those who are blind, clients often use this to purchase medicine or cover costs of extended health care

Question 64

diagnosis- related groups (DRGs)

Answer 64

reimbursement is made according to this classification system

Question 65

individual health

Answer 65

dimensions of individuality include the person's total character, self identity, and perceptions.

Question 66

individuality

Answer 66

to help clients attain, maintain, or regain an optimal level of health, nurses need to understand clients as individuals.

Question 67

concept of holism

Answer 67

nurses are concerned with he individual as a whole, complete, or holistic person. not as an assembly of parts and processes. the concept emphasizes that nurses must keep the whole person in mind and strive to understand how one area of concern relates to the whole person. pg 245

Question 68

Healthy People 2020

Answer 68

provided a framework for national health promotion, health protection, and preventive service strategy.

Question 69

health promotion

Answer 69

"behavior motivated by a desire to increase well-being and actualize human health potention" definied by healthy people 2020

Question 70

disease prevention/health protection

Answer 70

behavior motivated by a desire to actively avoid illness, detect it early, or maintain functioning within the illness.

Question 71

Health promotion VS Health Protection

Answer 71

Health Promotion: not disease oriented motivated by personal positive approach to wellness seeks to expand positive ``` Health Protection: Illness or injury specific motivated by avoidance of illness seeks to stop the potential for health occurrence of insults to heal and well being pg 249 ```

Question 72

Behavior- Specific Cognitions and Affect

Answer 72

read on page 251-252

Question 73

Stages of Health Behavior Change

Answer 73

precontemplation- the person doesn't think about changing in the next 6 months contemplation- person acknowledges a problem, gathers info, plans to change in the near future (next 6 months) preparation- intends to take action in the immediate future (a month) action- actively implements behavioral and cognitive strategies maintenance- the person strives to prevent relapse by integrating newly adopted behaviors into his or her lifestyle. termination- the ultimate goal; the point at which the individual has complete confidence that the problem is no longer a temptation or threat. pg 253

Question 74

nurse's role in health promotion

Answer 74

-model healthy lifestyle behaviors and attitudes - teach clients self care strategies - educate clients more in box on page 253