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NU320 Final > Practice Excellence > Flashcards

Practice Excellence Flashcards

1
Q

empathy vs. sympathy

A

empathy - fuels connection

sympathy - drives disconnection

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2
Q

empathy

A

predominantly cognitive (as opposed to affective) attribute that involves understanding (rather than feeling) of patient’s concerns, experiences, pain and suffering combined with a capacity to communicate this understanding and an intention to help

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3
Q

components of an assertive statement

A

get attention - call person by name
express concern
state the problem - brief, clear objective
propose a solution (don’t ask yes/no question)

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4
Q

notes on statements

A

there are no absolute right or wrong answers
this is a brief 7-10 second statement

key issues:

  • all 4 parts of the statement used?
  • problem statement is brief, factual, non-provocative
  • solution is not a yes/no question
  • is the focus on solving the problem and/or turning attention back to the patient?
  • NO sarcasm
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5
Q

nurses with effective clinical skills:

A

have better skills to recognize symptoms of patient deterioration

can better manage the care of the deteriorating patient effectively

decrease the rate of failure to rescue

have a positive impact on pt outcomes by decreasing pt morbidity and mortality rates

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6
Q

clinical reasoning components

A

think in action and reason as a situation changes over time

capture and understand significance of clinical trends

filter clinical data to recognize what is important

grasp the essence of the current situation

identify if a problem is present

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7
Q

8 essential steps for clinical reasoning

A

primary problem and the underlying cause/patho of this problem

clinical data from the chart is relevant and needs to be trended

nursing priority that captures the patient’s current status guides your plan of care

nursing interventions based on this priority and the desired outcomes

body system(s) based on patient’s primary problem or nursing care priority

worst possible/most likely complications to anticipate based on problem

nursing assessments that identify complications early

nursing interventions if complication develops

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8
Q

failure to rescue

A

a situation in which a health care team or member was unable to mitigate preventable harm to patients

failure to recognize and apparently respond to early signs of patient deterioration

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9
Q

failure to rescue is a failure to:

A

recognize clinical deterioration

communicate and escalate concerns

physically assess the patient

diagnose and treat the patient appropriately

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10
Q

what contributes to failure to rescue

A

inability to recognize important signs and symptoms

nurse staffing

poor management of preexisting conditions

communication failure

poor teamwork

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11
Q

integral to prevention of failure to rescue

A

attentive bedside care

vigilance in patient assessment

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12
Q

strategies to prevent failure to rescue

A

electronic health record

rapid response team

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13
Q

proactive vs. reactive

A

proactive is more preferred

reactive is reacting to a problem after it arises while proactive is preventing the problem before it arises

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14
Q

QI and research

A

support clinical decision making, support outcomes, utilize data collection, conduct systematic analysis

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15
Q

QI

A

improve care and/or processes for a specific healthcare organization

maybe based on EBP

results are specific to the patients, staff, organization

management tool

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16
Q

components of QI

A

purpose - understand and improve process/experience

who benefits? patients, organization, staff

scope - within an organization

timing - quicker activities; minimal to moderate resource requirements

design - process based; plan, do, study act

outcome measures - simple measures

sample - available patients; size determined by availability

informed consent - not required

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17
Q

research

A

generate new knowledge

test an intervention about a phenomenon

theory based

results are generalizable to greater population

18
Q

components of research

A

purpose - create new knowledge

who benefits? clinicians/researchers; scientific community

scope - general population

timing - longer time frame; resource requirements dependent on the study

design - scientific, systematic; quantitative or qualitative

outcome measures - complex measures; valid, reliable, specific and sensitive

sample - based on study purposes; size determined by power analysis or saturation

informed consent - required (and IRB)

19
Q

plan for Q1: falls cycle 1

A

I plan to test hourly rounding intervention on ortho units

I hope this produces a reduction in falls

steps to execute:
review intervention with nurses and techs on unit at staff meeting
place hourly rounding checklists on patient’s white boards

20
Q

Do for Q1: falls cycle 1

A

what did you observe

21
Q

study for Q1: falls cycle 1

A

what did you learn? did you meet your measurement goals?

22
Q

act for Q1: falls cycle 1

A

what did you conclude from this cycle?

23
Q

discuss the impact of medical errors on patients and families in the U.S.

A

failure of an action to be completed as intended or use of the wrong plan to achieve an aim

does not always result in patient harm

24
Q

adverse effects

A

harm to patient as a result of medical care, not the underlying illness; preventable vs unpreventable

25
Q

importance of reporting med errors

A

history repeats itself (without intervention) - humans will make errors

26
Q

goal of reporting meds

A

identify a system problem at the root of error(s)

  • design
  • educate
  • mandate
27
Q

patient safety and team SAFE

A

to err is human: building a safer health system

crossing the quality chasm

health professions education: a bridge to quality

framework for action on interprofessional education and collab practice

the future of nursing: leading changes, advocating health

28
Q

to err is human: building a safer health system

A

recommended interdisciplinary team training to increase patient safety and quality health care

29
Q

crossing the quality chasm

A

stated need for all health professionals to be educated to deliver pt-centered care as members of an interdisciplinary team, emphasizing evidence-based practice, quality improvement approaches, and informatics

30
Q

health professions education: a bridge to quality

A

noted that once in practice, health professionals are asked to work in interdisciplinary teams, yet they are not educated together or trained in team-based skills

31
Q

framework for action on interprofessional education and collab practice

A

defines interprofessional education (IPE) and collab practice (CP), noting relationship between the two and role interprofessional collab will play in mitigating the global health workforce crisis

32
Q

the future of nursing: leading changes, advocating health

A

stated that nurses should be full partners, with physicians and other health professionals, in redesigning health care in the U.S.

33
Q

CUS

A

I am Concerned, I am Uncomfortable, this is a Safety issue

34
Q

two challenge rule

A

empowers all team members to “stop the line” if they sense or discover an essential safety breach

when an initial assertive statement is ignored, it is your responsibility to assertively voice your concern at least two times to ensure it is heard

the team member being challenged must acknowledge that concern has been heard

if the safety issue still hasn’t been addressed, take a stronger course of action or utilize supervisor or chain of command

35
Q

why do errors occur

A 
workload fluctuations
interruptions
fatigue
multi-tasking
failure to follow up
poor handoffs
ineffective communication
not following protocol
36
Q

fishbone diagram

A

graphic tool to explore, sort, and display contributing causes of a given event; divided into four categories

37
Q

four categories of fishbone diagram

A

process - no process for supervising procedures overnight

team - timeouts not routinely performed for bedside procedures

communication - potentially critical image not discussed with radiology

equipment/technology - radiology system allowed a “flipped” exam

led to wrong side surgery

38
Q

team STEPPS

A

national evidence-based teamwork and communication framework to enhance patient safety

39
Q

Team SAFE student program designed to

A

impart principles of interprofessionalism

teach specific skills to enhance teamwork and communication

provide an opportunity to apply principles and skills

40
Q

skills for team SAFE

A

leadership
communication
mutual support
situation monitoring

NU320 Final (4 decks)

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