Professional Practice Flashcards
1
Q
Name the First 6 Nursing Standards of Care/Professional Practice
A
- Assessment
- Diagnosis (actual or potential -> problems and issues related to cancer and other health concerns of the patient)
- Outcome identification - identify expected outcome, focus on health promotion & maintenance, symptom management, rehabilitation or a comfortable death
- Planning - > develop POC with interventions to attain expected outcomes
- Implementation -> implement PoC
5.a - Coordination of care
5.b - Health Teaching/Health Promotion - Evaluation, systematically and regularly evaluates progress toward expected outcomes
2
Q
Name 7-12 Nursing Standards of Care/Professional Practice
A
- Ethics
- Culturally Congruent Cae
- Communication
- Collaboration
- Leadership
- Education
3
Q
Name 13 -17 Nursing Standards of Care/Professional Practice
A
- Evidence Based Practice & Research
- Quality of Practice
- Professional practice evaluation
- Resource Utilization
- Environmental health
4
Q
Name 6 ways to apply standards of practice and education
A
- Guide institution-specific PoC
- Frame/prioritize quality improvemtns
- Develop staff education activites/learnnig
- Develop staff performance eval. tools
- Determine research opportunities in oncology nursing
- Guide leadership development activities
5
Q
Name 6x Institute of Medicine (IOM) 2013 components for quality care:
A
- Engaged patients
- Adequately trained, staffed, and coordinated workforce
- Evidenced-based care
- A learning healthcare information technology system for cancer
- Translational research, transforming evidence into clinical practice, quality measurement, and performance improvement
- Accessible and affordable health care
6
Q
According to CMS (Centers for Medicare & Medicaid Services), good quality health care is adhering to this 5-step process ->
Name the steps.
A
According to CMS, good quality health care means:
1. doing the right thing
2. at the right time
3. in the right way
4. for the right person
5. and getting the best possible results
7
Q
ONS (2022) defines quality care as fulfilling these 6 criteria. Name the criteria.
A
- safety
- efficacy
- timeliness
- patient-centered approach 5. coordinated by an interprofessional team
- integration of EBP to continuously improve care
8
Q
Name 10 Key characteristics of Nursing Professional performance
A
- Collaboration
- Communication
- Education
- Environmental Health
- Ethics
- Evidence-based practice and research
- Leadership
- Professional practice evaluation/Self-awareness
- Quality of practice
- Resource utilization
9
Q
ONS Professional performance and excellence in oncology nursing requires leadership, knowledge, and skills for lifelong learning and career development.
List five domains specified by the ONS Leadership Competency Project that are integral to achievement of Leadership Competencies:
A
5 domains identified as important based on ONS Leadership Competency Project:
- Personal mastery
- Vision
- Knowledge
- Interpersonal effectiveness
- Systems thinking
10
Q
True or False:
Patient navigation models are applicable only to cancer care
A
False
11
Q
Name the core function of Patient Navigation
A
Elimination of barriers to timely cadre across all segments of the healthcare continuum
12
Q
True or False
Patient Navigation Research Program (PNRP) encompasses all cancer diagnoses
A
False
13
Q
True or False
Patient Navigation Research Program (PNRP) is overseen by the Centers for Medicare and Medicaid Services
A
False
14
Q
True or False
Patient Navigation Research Program (PNRP) is focused on populations experiencing cancer health disparities
A
True
15
Q
Name 9 Principles of Patient Navigation
A
- Patient-centric
- Integrate a fagmented healthcare system for the individual patient.
- Elimination of barriers to timely care across all segments of the healthcare continuum.
- Require clear scope of practice that distinguishes the role and responsibilities of the navigator from that of all other providers.
- Should be cost-effective with training and skills necessary to navigate
- Who should navigate -> determined by the level of skills required at a given phase of navigation (ie. RN vs. lay).
- Defne the point at which navigation begins and the point at which navigation ends.
- Navigation can serve as the process that connects disconnected healthcare systems
- Patient navigation systems require coordination.
16
Q
Name 3x Navigation Metrics
A
3x Navigation Metrics:
- Patient experience
- Clinical outcomes
- Business performance / Return on investment
17
Q
Name 6 Key points to build a culture of quality and patient safety
A
Key points to build a culture of quality and patient safety
- Quality methodologies
- Tools to measure quality and safety
- Strategies to sustain quality
- Safety and quality monitoring
- Standards of care
- Creating a healthy work environment
18
Q
What is SQUIRE?
A
Standards for QUality Improvement Reporting Excellence
Methodology for reporting Quality Improvement initiatives in effort to advance healthcare (quality, safety, effectiveness, patient-centeredness, timeliness, cost, efficiency, and equity of healthcare)
SQUIRE 2.0 Methods range from iterative changes using plan–do–study–act cycles in single settings to retrospective analyses of large-scale programmes to multisite randomised trials.
19
Q
Contrast Measurements to QI vs. Research in terms of:
- Knowledge
- Testing
- Data
- Duration
A
Knowledge:
R: Discovery
QI: Application for daily practice
Testing:
R: blinded, one-time, randomized, multicenter
QI: Multiple sequential small observable cycles of testing
Data:
R: Gather lots, analysis later
QI: Gather small bits, adjust, repeat testing cycle
Duration:
R: months-years
QI: incremental, accelerated change
20
Q
ONS position: access to quality care
A
HC to all populations w/o discrimination & affordable
Oncology RNs provide essential services: at all points along care continuum
CNE programs & Practice guidelines for RNs to enable preparedness to meet patient needs
Diverse RNs similar to populations served
Holistic, culturally sensitive care, in-person or Telehealth -> enable understanding of ca & how ca treatments affect wellness
Advocacy efforts to reduced costs & enable access to treatments (insurance, oral agents, costs of care)
access to full choice of HC providers including APRNs with financial coverage
21
Q
What METHODS (acronym) does the Joint Commission Center for Transforming Healthcare and its participating organizations use?
Are systematic approaches used?
List 6 GOALS
A
Robust Process Improvement® (RPI) methods and tools
YES: The use of improvement models applies a systematic approach to solving complex problems.
GOALS - Improve Organizational:
1. effectiveness
2. efficiency
3. customer satisfaction
4. compliance
5. culture
6. documentation
22
Q
Name 5 Standards of Professional Performance (performance reviews based on)
A
I. Quality of Care
2. Practice Evaluation
3. Education
4. Collegiality
5. Ethical principles to guide decisions and advocacy
23
Q
What are Quality and Safety Tools and Models?
List 6 examples
A
Tools to Measure Quality and Safety
1* Control charts
2* The Pareto chart
3* Cause and effect diagram
4* Scatter diagram
5* Physician Practice Patient Safety Assessment
6* Pathways for Patient Safety
24
Q
What is Plan-Do-Study-Act (PDSA) module used for?
What is it often called?
What is the 3-step process preceding the PDSA?
A
PDSA model is an EBP model (backbone of the Lean Six Sigma strategy) for quality Improvement.
Often called the Model for Improvement (MFI)
3-step process:
AIM: Identify the QI goal
CHANGE IDEAS: Hypothesize actions that may help to achieve the goal
MEASURE: Determine what can be measured to validate improvement toward the goal
—- THEN -> PDSA
25
What is PICOT?
PICOT is the framework for nursing literature; is used to frame a Literature search Question. The PICOT question Includes:
P-population
I- Intervention of interest
C- Comparison intervention
O- Outcomes
T- Time (time till clinical outcome observed)
26
In the PDSA Cycle,
First step = P, explain.
P = PLAN
1. Objective (goal)
2. Outcome predictions
3. Implementation plan (who, what, where, when, how)
4. Measurement plan
27
In the PDSA Cycle,
Second step = D, explain.
D = ACT
1. Carry out the plan
2. Document problems and unexpected observations
3. Begin data analysis
28
In the PDSA Cycle,
Third step = S, explain.
S = STUDY
1. Complete data analysis
2. Compare to predictions
3. Summarize what was learned
29
In the PDSA Cycle,
Fourth step = A, explain.
A = ACT
1. What changes are to be made next cycle?
2 Action based on prior results
30
What is QSEN?
Name 6 QSEN competencies
QSEN = Quality and Safety Education for Nurses
Name 6 QSEN competencies:
1. Patient-Centered Care
2. Teamwork and Collaboration
3. Evidence-based Practice (EBP)
4. Quality Improvement (QI)
5. Safety
6. Informatics
31
Name 3x Data Sources for EBP.
1. Research based evidence (ie. clinical trials, observational, descriptive, or correlational studies)
2. Theoretic evidence (prepositions based on empiric and non-empiric knowledge)
3. Non-research evidence (ie chart review, QI analysis, international and/or local SoC, case reports, infection control data, etc)
-
32
List the 5x Levels of evidence hierarchy, which level is the highest quality?
5x Levels of evidence hierarchy
LEVEL 1: HIGHEST Quality of evidence: Randomized controlled trials; testing previously described diagnostics on MANY patients; systematic reviews of MANY level 1 studies (ie RCT) with multiple analysis
LEVEL 2: Prospective comparative studies; retrospective studies; development of diagnostics, limited reviews on level 1 studies with inconsistent results; systematic reviews of LIMITED level 1/ Level 2 studies with multiple analysis
LEVEL 3: Case control study (therapeutic / prognostic); retrospective comparative; analysis of nonconsecutive patients without consistently applied "gold standard"; systematic review of level 3 studies; reviews of LIMITED alternatives/costs/poor estimates
LEVEL 4: Case series; case control study (diagnostic); poor reference standard; analyses with no sensitivity analyses
LEVEL 5: Expert opinion
33
What term best describes: to give official authorization or approval of” and “to recognize as conforming with a standard.”
Accreditation
34
What term best describes: confrmation of certain characteristics of an object, person, or organization
Certification
35
What is the Joint Commission Enterprise?
A global driver of QI and patient safety in health care.
36
What is the Joint Commission Mission?
The mission of The Joint Commission is Consistently Excellent Health Care, to continuously improve health care for the public, in collaboration with other stakeholders, by evaluating health care organizations and inspiring them to excel in providing safe and effective care of the highest quality and value.
37
What is the Joint Commission Vision?
Joint Commission Vision: all people always experience the safest, highest quality, best-value health care across all settings.
38
How does the Joint Commission achieve it's Mission and Vision?
By setting quality standards, evaluating an organization’s performance, and providing an interactive educative experience that provides innovative solutions and resources to support continuous improvement.
39
Joint Commission Accreditation last for how many years
1. Most Organizations
2. Labs
1. three years for most organizations
2. two years for labs
40
True or False
Joint Commission-accredited health care organizations can seek certification for care and services provided
True
Joint Commission-accredited health care organizations may seek certification for care and services provided for virtually any chronic disease or condition.
41
True or False
Non-accredited organizations can still be eligible for Joint Commission certification
True
For some select certifications a non-accredited hospital can apply for certification if they are part of a hospital that is compliant with applicable federal laws, including Medicare Conditions of Participation.
42
True or False
Certification requires an evaluation by The Joint Commission
True
Like accreditation, certification requires an evaluation by The Joint Commission. It covers compliance with the standards and verifies improvement activities. After earning certification, you will receive The Gold Seal of Approval®, our internationally recognized mark of quality.
43
Name the consortium of professional organizations devoted to improving survival and quality of life for patients with cancer; this consortium of organizations specifies standards for quality, interprofessional practice, and comprehensive cancer care delivery and functions to:
* Conducts surveys to assess application of and compliance with those standards.
* Collects data from Commission on Cancer–accredited settings.
* Uses collected data to monitor treatment patterns and outcomes and clinical
surveillance activities.
* Develops educational programming to improve cancer prevention, detection, care
delivery, and outcomes.
* Promotes consultation among surgeons, medical and radiation oncologists,
pathologists, diagnostic radiologists, and other cancer specialists.
American College of Surgeons Commission on Cancer
44
Which organization
Established in 1987 awards accreditation for programs in:
- breast imaging
- stereotactic biopsy
- computed tomography (CT)
- magnetic resonance imaging (MRI)
- breast MRI
- positron emission tomography (PET)
- ultrasound
- nuclear medicine
as mandated under the Medicare Improvements for Patients and Providers Act (MIPPA), as well as for modalities mandated under the Mammography Quality Standards Act?
The American College of Radiology
45
Which organization
Established in 1987 awards accreditation for modalities:
- Breast MRI
- Breast Ultrasound
- CT
- Mammography
- MRI
- Nuclear medicine / PET
- RT Oncology Practice
- Stereotactic Breast Biopsy
- Ultrasound
The American College of Radiology
46
Which entity accredits organizations that comply with current standards related to the exchange or use of cellular products.
What year founded?
Meeting these requirements demonstrates a commitment to controlling every aspect that impacts the quality of products and therapeutic care in the complex field of cellular therapy, blood and marrow transplantation.
Name 4x areas of Accreditation
The Foundation for Accreditation of Cellular Therapy.
Founded
4x areas of Accreditation:
1. Hematopoietic Cellular Therapy
- Standards includes hematopoietic progenitor cells (HPCs), nucleated cells or mononuclear cells from any hematopoietic tissue source collected for therapeutic use other than as HPCs, immune effector cells (IECs), and genetically modified cells)
2. Immune Effector Cells
- Standards include ie. dendritic cells, natural killer cells, T cells, and B cells
3. Common for Cellular Therapies
- Standards include: basic fundamentals of cellular therapy that can be applied to any cell source or therapeutic application, and are intended to be used throughout product development and clinical trials
4. Cord blood banking
- Standards aim to to achieve consistent production of high quality placental and umbilical cord blood units for administration
47
True or False
The Foundation for Accreditation of Cellular Therapy is the ONLY accrediting agency that addresses all quality aspects of cellular therapy and cord blood banking (including collection, processing, and administration).
True
48
True or False
Nurses have No impact or role in the accreditation process (development, implementation, and ongoing success)
False
Nurses play a critical role in the accreditation process
49
What are 8x examples of Nursing Roles in the Accreditation Process?
Nursing responsibilities the Accreditation Process include:
1. Participation in PI and QI (Quality Improvement) at the microsystem, mesosystem, and macrosystem
2. Focus on patient safety and creating a healthy work environment
3. Knowledge of accrediting bodies, standards, and quality measures
4. Participation in ongoing surveillance programs through data collection, management, and analysis
5. Identifcation, development, implementation, and analysis of quality measure specifc to patient care outcomes
6. Participation in preparatory activities (mock surveys, tracers, daily checklists)
7. Promotion of high performing teams and organizations
8. Participation in evaluative and debriefng activities for continuous learning and improvement
50
List 5 qualities of High Reliability Teams and Organizations which are relevant to maintaining quality and accreditation to promote safety across all care settings
1. Preoccupation with failure
2. Reluctance to simplify
3. Sensitivity to operations
4. Resilience
5. Deference to expertise
51
In 2015 Lacovara initiated a call to action for Oncology nurses to promote healthy practice environments consisting of 14 items:
1. Adequate staffing
2. Authentic leadership
3. Autonomous nursing practice
4. Collegial and collaborative interdisciplinary relationships
5. Control over nursing practice
6. Culture in which concern for the patient is paramount
7. Effective decision making
8. Meaningful recognition
9. Perceived adequacy of staffng
10. Practicing with clinically competent nurses
11. Skilled communication
12. Support for education
13. Supportive nurse managers
14. True collaboration
52
Define Credentialing
Credentialing is the process of establishing the qualifcations of licensed professionals, organizational members, or organizations and assessing their background and legitimacy.
53
List an example of Credentialing that specifies Nursing excellence.
ANCC's (American Nurses Credentialing Center) Magnet Recognition Program is a credentialing body in nursing.
"Magnet status" is not an award but a credential of organizational and hospital recognition of nursing excellence
54
List 5x Attributes of Magnet Hospitals
Attributes of Magnet hospitals include:
1. Supportive and collegial interprofessional clinical practice
2. Autonomous, engaged RN workforce
3. Successful achievement of quality outcomes for patients, nurses, the organization, and the community
4. Culture of excellence
55
List 5x Magnet Model Components
5x Magnet Model Components:
1. Transformational Leadership
2. Structural Empowerment
3. Exemplary Professional Practice
4. New Knowledge, Innovations, and Improvements
5. Empirical Outcomes
56
List 5x Magnet Recognition Benefits
5x Magnet Recognition Benefits
1. Attract and retain top talent
2. Improve patient care, safety, and satisfaction
3. Foster a collaborative culture
4. Advance nursing standards and practice
5. Grow the business, resulting in financial success
57
What is VARK?
VARK = Acronym for learning styles questionnaire:
V = Visual
A = Aural
R = Read/Write
K = kinesthetics (Senses, Practical exercise, hands-on, Do)
58
List 6x Barriers to effective learning (In terms of patient education)
Barriers to effective learning may include:
1. Insuffcient knowledge (ie. diagnosis and treatment options)
2. Incongruence between expectations of treatment outcomes and realistic treatment goals
3. Language and literacy barriers
4. Physical barriers (ie pain, visual, hearing impairment, cognitive defcits)
5. Psychosocial issues
6. Prior experiences within the healthcare environment, or prior experiences of a friend or relative
59
List 8 strategies to overcome patient education barriers
Strategies to overcome barriers include:
1. Provide distraction free environment
2. Mitigate physical barriers (ie pain medication, glasses, hearing aids).
3. Interpreter
4. Allow verbalization of concerns, fears, and anxiety.
5. Assess literacy level and tailor teaching to understanding.
6. Correct misconceptions and misinformation.
7. Provide alternative teaching resources (e.g., video, literature, web-based).
8. Assess for comprehension; adjust/review as needed.
60
Adult Learning Theory (Androgagy) specific items
1. Self-Directed: What's in it for me? Why do I need to know? (self-directed independent, and problem centered)
2. Take responsibility for learning: autonomy with decisions, choosing what is desired to be learned, though the RN must enable assessment of own learning through self-assessment and feedback
3. Learning Based on Past Experience: can be a plus (vast resource) and also a minus (bias and presuppositions)
4. Learn when they choose and commit
5. Task-oriented, training should be task-centered
61
Standard of Professional Performance
Name 5x ONS Standards of Professional Performance
5x ONS Standards for Professional Practice:
I: Quality of Care
II: Practice Evaluation
III: Education
IV: Collegiality
V: Ethical Principles
62
Name 3x Components to Behavioral Learning Theory & 3x examples
3x Components to Behavioral Learning Theory:
1. Operant conditioning
2. Classical conditioning
3. Key = Positive reinforcement; Learning based on observable behaviors that are reinforced to increase the strength of the behavior
3x Examples:
1. Relaxation techniques
2. Biofeedback
3. Visual imagery
63
Name 3x Components Cognitive Learning Theory and name 4x examples
2x Components of Cognitive Learning Theory:
1. Looks at the way people think and describes the internal process that leads to learning (Plato, Descartes, Piaget)
2. Requires attention and information to be retrieved and applied
3. Tools: Ask questions, have opportunity to make errors, foster self-reflection & self-questioning, thinking aloud.
Example:
1. SBAR: Creation of mnemonic for symptoms that should trigger a phone call to MD
2. Lectures
3. Brainstorms
4. Discussions
64
Describe Social Learning Theory and name 1x example
Social Learning Theory Describes learning based on:
1. Watching and limiting others, idea that learning happens in a social context and is impacted by the person, environment, and behavior
Example: Client-to-Client volunteers
65
Describe Motivational Learning Theory and name 1x example
Motivational Learning Theory
Results from personal (internal) cues or environment (external) cues
Example:
Smoking cessation
- internal: to be present for children
- external: workplace non-smoking environment
66
Describe what are Learning Goals
Learning Goals:
Describe intended learning outcomes.
67
Describe Learning Objectives
Objectives: like blueprints, provide the guides that will guarantee you are teaching what needs to be taught
- An objective is about end rather than means. It describes a product of
instruction rather than the process of instruction
- An objective describes student performance. It doesn’t say anything
about what the instructor will do or try to accomplish. It doesn’t describe course content or the textbook
68
In terms of Learning Objectives, what is acronym SMART?
SMART is nemonic for identifying appropriate Learning Objectives:
S = specific
M = measurable
A = attainabile
R = realistic
T = timed
69
Ethical Principles include:
1. autonomy
2. beneficence
3. nonmaleficence
4. justice
List link to resolving ethical issues
Ethical Principles such as:
1. autonomy
2. beneficence
3. nonmaleficence
4. justice
Are helpful in analyzing ethical situations
70
Define Living Will
Name advantages
Name disadvantages
The patient must have a terminal condition (life expectancy = 6mo. or less); this document specifies treatment that the patient
does not want if dying (e.g., CPR, blood transfusion, ventilator support, dialysis, surgery).
In some states, the patient may not forgo nutrition and hydration.
Advantages:
Patient can list specific
conditions and specific
treatments to be withheld
or withdrawn.
Disadvantages
Variations between states
exist regarding interpretation, so nurses should check with their institution’s legal department regarding a patient forgoing nutrition and hydration.
71
Define DPOA
Name advantages
Name disadvantages
Durable Power of Attorney:
Document designates a surrogate decision-maker if the patient is no longer able to participate in decision-making.
Surrogate can make all the decisions that the patient would have made if capable, including
decision to forgo nutrition and hydration
Advantages
Surrogate may authorize
treatment as well as the
withdrawal of treatment,
including nutrition and
hydration.
Disadvantages
It may not be clear if
surrogate is following the
patient’s wishes or making decisions based on what the surrogate would
choose, not what the
patient would choose.
72
Define Do-not-resuscitate
(DNR) order
Name advantages
Name disadvantages
DNR = Physician order in
patient’s medical record specifying what measures are to be withheld if there is cardiac or respiratory arrest that will result
in death if not treated
Advantages
A DNR order clarifies for
the rest of the healthcare team what should be
done if there is a cardiac or respiratory arrest
Disadvantages
A DNR order can be
written by the physician without consent
of the patient or family, which can create conflict and tension between
the patient, family, and
healthcare team.
73
True or False
Ethical issues faced by patients, families, and nurses in oncology settings are pervasive.
True
74
True or False
Moral distress among nurses and other professionals caring for patients with cancer INFREQUENTLY occurs.
False.
Moral distress among nurses and other professionals in oncology OFTEN occurs.
75
What institutional resource can assist patients, families, and staff with conflicts regarding end-of-life care,
informed consent, advance directives, and issues related to the futility of treatment?
Institutional ethics committees
76
Ethics: Define Autonomy
Individual able to make decisions consistent with their own values
77
Ethics: Define Beneficence
treatment/intervention should benefit recipient
78
Ethics: Define Nonmaleficence
Avoid or minimize harm
79
Ethics: Define Justice
fair allocation of HC resources based on need and expected outcome
80
Name 5 common Ethical dilemmas encountered in Oncology
1. Requests for physician-assisted dying
2. Terminal sedation
3. Conficting do-not-resuscitate requests
4. Uncontrolled pain or other symptoms
5. Awareness of impaired practice in a colleague or personally
81
What is CLAS?
What are 2x benefits?
CLAS = culturally and linguistically appropriate services.
Benefits:
1. ultimately help reduce health disparities and achieve health equity.
by improving the quality of services provided to all individuals
2. Respecting the whole individual and Responding to the individual’s health needs and preferences can help close the gap in health outcomes.
82
Legal Issues:
RNs are bound by professional practice scope, standards, and guidelines, detailed by a minimum of 3x entities. Name the 3x entities.
1. Nurse Practice Act (that is in effect in the US state in which the RN practices)
2. ANA - American Nurses Association - Code of ethics with interpretive statements
3. Employer / organization standards and practice guidelines
83
Legal Issues:
Define Negligence
Negligence = deviation from the acceptable SoC that a reasonable person would use in a specific situation
84
Legal Issues:
Define Malpractice
Malpractice = deviation from a professional SoC
85
Legal Issues:
Define Duty
Duty = Care relationship between the client & provider
86
Legal Issues:
Define Breach of Duty
Breach of Duty = Failure to meet an acceptable SoC
87
Legal Issues:
Define Defamation
Defamation = the act of harming the reputation of another by making false statements to a 3rd person.
88
Legal Issues:
Define False imprisonment
False imprisonment = a restraint of a person in a bounded area without justification or consent
89
Legal Issues:
Define Slander
Slander = A defamatory statement expressed in a transitory form, especially speech
90
Legal Issues:
Define Proximate Cause
The cause that directly produces an event and without which the event would not have occured
91
Legal Issues:
Define Civil
Civil = Of or pertaining to private rights & remedies that ae sough by action or suit, but distinct from criiminal proceedings
92
Legal Issues:
Define Assault
Assault = The threat or use of force on another that causes that person to have
a reasonable apprehension of imminent harmful or offensive contact
93
Institution Regulation and Risk Management.
Is partially regulated by governmental and nonprofit agencies.
Name 5x ways how governmental and nonprofit agencies can have an effect
When standards are not upheld:
1. fines
2. penalties
3. loss of accreditation
4. loss of funding
5. other punitive responses
94
Institution Regulation and Risk Management.
List one example of how CMS can have an effect
CMS can reduced reimbursement for specific acquired conditions ie
- air embolism
- falls / trauma
- catheter associated UTI
- vascular catheter associated infection
- poor glycemic control
95
Institution Regulation and Risk Management.
List one example of how the Joint Commission can have an effect
the Joint Commission
- will conduct unannounced, on-sit evaluations, particularly if a consumer complaint has been made
- may change accreditation status based on findings
96
Institution Regulation and Risk Management.
List one example of how the OSHA (occupational safety and health admin) can have an effect
OSHA (occupational safety and health admin)
- will investigate complaints / concerns related to worker exposure to hazardous drugs and inspect biologic safety controls
97
Nurses are at risk for legal charges due to hands-on nature in many cases.
List 11x examples of charges:
1. Negligence (lawsuit based on malpractice)
2. Practicing beyond scope (licensure violation)
3. Practicing without a license
4. Drug diversion and/or distribution
5. Failure to obtain ICF
6. Failure to provide patient safety
7. Violation of confidentiality
8. Invasion of privacy
9. Libel - A defamatory statement expressed in a fixed medium, especially writing but also a picture, sign, or electronic broadcast
10. False imprisionment - A restraint of a person in a bounded area without justification or consent
11. Battery - The use of force against another resulting in harmful or offensive contact
98
Nurses are at risk for legal charges due to hands-on nature in many cases.
List 8x common practice areas for which RNs have been sued:
1. medication errors
2. failure to adequately monitor
3. failure to document care
4. acting outside scope of practice
5. nonadherene to accepted SoC
6. Failure to diagnose (NP)
7. Breach of confidentiality
8. Practicing while impaired / not reporting another who is impaired
99
