quiz 1 Flashcards
(165 cards)
1
Q
accountability
A
the responsibility professionally and legally, the type and quality of nursing care provided
2
Q
advocacy
A
protect patients human and legal rights and provide assistance in asserting those rights if the need arises
3
Q
autonomy
A
initiation of independent nursing intervention without medical orders
4
Q
beneficence
A
taking positive actions that help others
5
Q
bioethics
A
branch of ethics within science and medicine
6
Q
casuistry
A
turns away from conventional principles of ethics as a way to determine best way of practice
7
Q
nursing code of ethics
A
set of guiding principles that all members of a profession accept
8
Q
key principles of code of ethics for nursing
A
advocacy
responsibility
accountability
confidentiality
9
Q
confidentiality
A
healthcare team’s obligation to protect pt’s privacy
10
Q
deontology
A
defines actions as right or wrong based on their adherence and to rules and principles such as truthfulness, fidelity to promises, and justice
11
Q
ethics
A
study of what is right or wrong with our conduct
12
Q
ethics of care
A
offers an alternative view to utilitarianism and deontology
13
Q
feminist ethics
A
view holds that the natural caring of others is the basis for moral behavior; places emphasis on caring relationships, and a strong sense fo responsibility, focuses more on practical solutions
14
Q
fidelity
A
faithfullness on the agreement to keep promises
15
Q
justice
A
treating everyone fairly
16
Q
morals
A
judgment about behavior based on specific beliefs
17
Q
nonmaleficence
A
do not harm
18
Q
utilitarianism
A
measures the effect and act will have
19
Q
value
A
deeply held belief of the worth of an idea, custom, or attitude, or objects, that affects behavior
20
Q
values clarification
A
to resolve ethical conflicts one needs to distinguish among value, fact and opinion
21
Q
approaches to ethics
A
- deotonology
- utilitarianism
- casuistry
- feminist ethics
- ethics of care
22
Q
types of ethical problems
A
ethical dilemma
moral distress
23
Q
ethics comitees
A
make informed decisions that may be difficult for nurse
24
Q
processing an ethical problem
A
- aks is this an ethical problem?
- gather information that is relevant to the case
- identify the ethical elements in the problem and examine your values
- name the problem
- identify possible cours eof action
- create-implement an action plan and carry it out
- evaluate the action plan
25
issues in health care ethics
social media
quality of life
care the end of life
access to health care
26
bioethics
specific domain of ethics that is focused on moral issues in the field of health care
27
nuremberg trials
1947
focused on the unspeakable treatment of prisoners of war during WWII with a storng focus on the incarceration of people of jewish faith strictly because of their ethnic and religious affiliaiton
28
watson and clark
1953
presented on the of first publications describing DNA - concept that was beginning to be explored
29
first renal transplant
1954
movement in medical practice recognized the first kidney transplant
30
chronic hemodialysis
1960
posed questions for who would meet criteria for treatments that could not be provided for everyone in need
31
first heart transplant
1967
cape town south africa on december 3
dr. christiaan barnard
opened discussions for who and how this procedure would be implemented
32
definition of brain death
1968
first discussion of brain death was presented with discussion of how and who would perform this assessment, what decisions might be made for patient care after this determination would be made
33
tuskegee syphilis research
1972
continuaiton of providing no treatment for subjects diagnosed with syphilis even after known treatment with antibiotics was established
premise was to further explore progression of diseases without intervention
ETHICALLY WRONG
34
roe v wade
1973
legal, moral, religious, and ethical questions related to choice for an abortion
35
karen ann quinlan
1975
removal of life support
36
baby louise brown
1978
initiation of pregnancy for the first time through invitro-fertilization (Baby Louise Brown)
37
first artifical heart
1982
first implementationof an aritifical heart
38
AIDS, as an epidemic
1983
epidemic of HIV/AIDS
39
dobbs vs jackson women's health organization
2022
reversal of roe v wade
40
belmont report
1978
respect for person
beneficence - do good
justice
outcoe of a professional meeting to review the pratice to date in 1978 to develop response for a health care providers tha directed professional care to the lists
41
principles of biomedical ethiccs
autonomy
nonmaleficence
benefence
justice
42
ethical principlism
provides guidelines that can be used to make justified, moral decisions and to evaluate the morality of actions
one of the most popular tools used today for analyzing and resolving bioethical problems
43
autonomy
freedom and ability to act in self-determined manner
44
informed consent
respecting a persons autonomy to make personal choices bsed on the appropriate appraisal of information about the actual and/or potential circumstances of a situation
45
patient self determination act
first federal statue designed to facilitate a patient's autonomy through the knowledge and use of advance directives
46
slippery slope argument
warning with no justification or formal, logical evidence to back it up; a situation taht could hypothetically slip towrd a morally unacceptable situation
ie physician assisted suicide
47
paternalism
deliberate overriding of a patient's opportunity to exercise autonomy because of a perceived obligation of beneficence
48
social justice
usually thought of in terms of how benefits and burdens should be distributed fairly among members of a society or ideally how all people in a society should have same rights, benefits, and opportunities
49
ethical dilema
situation in which an individual is compelled to make a choice between two actions that will affect the well-being of a person; neither action is "good"
50
reflection
involves stopping to think about what one is choosing and doing before and during one's actions
51
ethics comittee
usually consists of physicians, nurses, other health care providers, and on-staff chaplain, a social worker, a rep of organization staff, possibly a legal representative, and community members
52
to act professionally:
use critical thinking skills
administer quality PCC
be responsible and accountable
53
health care advoacy groups the
importance of the role nursing plays in a nations health care
54
Robert Wood Johnson Foundation (RWJF)
future of nursing: campaign for action
catalysts for change: harnessing the power of nurses to build population health in 21st century
55
nursing requires
current knwoledge and practice standards
insightful and compassionate approach
critical thinking and clinical judment
56
benner's stages of nursing proficiency
novice
advanced beginner
competent
proficient
expert
57
nursing definitions
ana
international council of nurses
58
professional responsibility and roles
autonomy and accountability
caregiver
advocate
educator
communicator
manager
59
APRN
- clinical nurse specialist
- nurse practitioner
- certified nurse widwife
- certified registered nurse anesthetist
60
nurses respond to
needs to patients and actively participate in determining best practices
61
florence nightingale
- established first nursing philosophy on health maintenance and restoration
- organized first program for training nurses
- first practicing epidemiologist
- improved sanitation in battlefield hospitals
- remain a basic part of nursing today
62
mary adelaide nutting
1906
instrumental in moving nursing education into universities
63
1920 nursing...
specialization began
64
1990 ANA established
center for ethics and human rights
65
1994 UWMC became
first magnet organization
66
nurses are revising nursing practice and school curricula to meet the needs of society:
- aging population
- cultural diversity
- bioterrorism
- emerging infections
- disaster managment
67
contemporary concerns
- nurses selfcare
- healthcare reform and costs
- demographic changes
- medically underserved
68
nursing trends
- EBP
- quality and safety education for nurses (QSEN)
- emerging technologies
- genomics
- public perception of nursing
- impact of nursing on politics and health policy
69
nurse practice acts (NPAs)
- overseen by state boards of nursing
- regulare scope of nursing practice
- protect public health, safety, and welfare
70
licensure and certification
NCLEX-RN
certification
71
clinical judgment is the outcome of
critical thinking and decision making
72
clinical decision making separates
professional nurses from technicians or other assistive personal (AP)
73
critical thinking
-ability to think in a systemic and logical manner with openness to question and reflect on the reasoning process
74
aim of critical thinking is the
ability to focus on the important issues in any clinical situation and make decisions that produce desired patient outcomes
75
general critical thinking
scientific method
problem solving
decision making
76
specific critical thinking
diagnostic reasoning
clinical decision making
77
components of critical thinking
competence
knowledge base
experience
environment
78
attitudes for critical thinking
confidence
independent thinking
fairness
responsibility and accountability
risk taking
discipline
79
evaluation of clinical judgments
reflection
meeting w colleagues
concept mapping
critical thinking analysis
80
2 steps of critical thinking
collection of information from a primary source and secondary source
interpretation and validation of data to determine whether more data is needed ro databsse is complete
81
types of assessment
patient centered interview - conducted during a nursing history
periodic assessments - conducted during ongoing contact with patients
82
phases of assessment interview
orientation and setting an agenda
working phase (collecting assessment data)
termination phase
83
interview techniques
observation
open ended and direct closed eneded questions
leading questions
back channeling
probing
84
environment in assessment
setting
time
task complexity
interruptions
85
intellectual standards
guide the manner in which a nurse pursues an assessment
86
professional standards of practice or clinical guidelines
apply standard criteria when assessing a pt
compare the patients actual assessment findings with what standard sets as normal or abnormal
87
components of nursing health history
- biographical information
- chief concern
- pt experience
- present illness or health concerns
- past health hx
88
assessment processs
data collection
validation
concept mapping
89
example of assessment process
pt looks uncomfortable in bed
pt shows discomfort in surgical area (cues: lies still with arms along sides: tense, states has not turned, 7/10 pain) inferences - pain is sever, liits pt ability
90
CJM
recognized cues
analyze cues
prioritize hypotheses
generate solutions
take action
evaluate outcomes
91
adpie
assessment
diagnosis or analysis
planning
implementation
evaluation
92
tanner model
noticing
interpreting
responding
reflecting
93
methods for prioritizing
high intermediate low based on ABCs
maslows hierarchy
consider each pt unique situation
avoid using only physiological nursing diagnoses as high priority
94
a patient centered outcome reflects a pt highest possible level of
wellness and independence in function
95
writing expected outcoes
specific
measurable
attainable
realistic
timed
96
types of intervention
direct care measures
indirect care measures
independent nursing interventions
dependent nursing interventions
other provider interventions
97
selection of interventions, consider
desired PO
characteristics of nursing diagnosis
research base knowledge for intervention
feasibility of doing intervention
acceptability to pt
nurse competency
98
systems for planning nursing care
- use of care plans in healthcare agencies
- student care plans
- care plans for community settings
- hand-off reporting
- concept maps
- critical pathways
99
when to consult
when problem is ID that you or interprofessional team can't solve
100
how to consult
ID general problem area
choose appropriate professional
provide consultant w relevant info
do not prejudice or influence
be available
incorporate consultants recommendations
101
standing orders
preprinted document containing medical orders for specific pt's w id clincial problems
102
nursing interventions classification (NIC) interventions
offer a level of standardization to enhance communication of nursing care across settings and to copare outcomes
103
quality and safety education for nurses (QSEN)
standard competencies in knowledge skills and attitudes for the preparation of future nurses
104
goal os QSEN
to prepare nusrses so that they cna continuously improve the quality and safety of health care systems within which they work
105
critical thinking allows you to consider the
complexity of interventions, changing priorities, alternative approaches, and amount of time to act
106
implementation process
avoiding adverse events
reassessing pt
reviewing and revising existing care plan
107
preparing for implementation
- time managment
- equipment
- personnel
- environment
- pt
108
anticipating and preventing complications
- ID area of assisstance
109
implementation skills
- cognitive
- interpersonal communication
- psychomotor skills
110
direct care
- ADLs
- instrumental activites of daily living
- physical care
- lifesaving measures
- counseling
- teaching
- controlling for adverse reactions
- preventative interventions
111
indirect care
interventions performed away from pt but on behalf of pt
- communicating nursing interventions
- delegating supervising, and evaluating work of staff members
112
achieving pt outcomes
- implement interventions in timely manner
- critically apply principles of care coordination (time management, organizational skills, appropriate use of resources, priority setting)
- promote patient adherance
113
CJ and CT in evaluation
- examine reuslts of care according to clinical data collected
- compare achieved effects or outcomes with expected outcome
- recognized errors or omissions
- understand a pt situation, reflect on situation and correct errors
114
elements of evaluation
knowledge
experience
standards and attitudes for evaluation
environment
115
examine results
evaluative measures
nursing outcomes classification
compare achieved effects with outcomes
interpreting and summarizing findings
116
patient centered care is achieved only when
a pt and family are actively involved in the evaluation process
117
evaluate whether the patient
reached the level of wellness or recovery that the health care team and patient established in outcomes of care plan
118
four nursing sensitive adverse outcomes
severe pressure injuries
falls and trauma
catheter associated urinary tract infections
central line associated blood stream infections
119
tanner model
developed from review of research on clinical judgment
recognizes role of nurses background
circumstances of situation
nurses relationshi with pt
120
requires range of knowledge
derived from science and theory, applicable to many situations
derived from practice grows with clinical experience
derived form knownig individual pt
dervied from human understanding
121
nurses know pt typical response pattern so
aspects of situation stand out readily recognized
122
qualitative distinctions are possible
current picture can be compared to patient's typical picturekn
123
knowing pt supports helps
individualize responses and interventions
124
analytic processes
break down situation into its elements to gain knowledge, adress mismatch between what is expect and what happens, determining action when there are multiple options
125
documentation is
a key communication strategy that produces written account of patient data, clinical interventions, and pt responses
126
documentation allows for
all members of healthcare team to track pt clinical course
127
purposes of the health care record
- facilitate interprofessional communication
- provides legal record of care
- provides justification for financial billing and reimbursement of care
- supports the process of needed for quality and performance improvement
- serves as a resources for education and research
128
interprofessional communication within the medical record
legal doc
reimbursement
auditing and monitoring
education
research
129
electronic health record (EHR)
individuals lifetime computerized record
130
electronic medical record (EMR)
the record for an individual health care visit
131
privacy confidentiality and security mechanisms
firewall
password
132
handling and disposing of information
procedures for nursing students
policies for the use of fax machines
133
guidelines for quality documentation
factual
accurate
appropriate use of abbreviations
current
organized
complete
134
standards and guidelines for quality nursing documentation
time documentation must be on accurate time stamps throughout
135
documentation of patient assessment data
flow sheets
progress notes
charting by exception
136
record keeping forms within the electronic health record
admission nursing history form
patient care summary
care plans
discharge summary forms
137
documenting com. w providers and unique events
telephone calls
telepone and verbal orders
incidence or occurrence reports
138
acuity rating system
used to determine hours of care and number of staff required for a group of patients every shift or every 24 hrs
139
patient's acuity level
based on the type and number of nursing interventions required by the patient over a 24 hr period
140
documentation in long term health care settings is governed by
individual state regulations
the joint comission
centers for medicare and medicaid services (CMS)
141
medicare has specific guidelines to
establish eligibility for home care reimbursement
142
nurses give two different data dets to document clinical assessments and care provided in the home care setting
oasis
omaha system
143
case management model
incorporates an interprofessional approach to delivery and documentation of pt care
144
critical pathways
interprofessional care plans that identify patient problems, key interventions, and expected outcomes within an established time frame
145
variances
unexpected outcomes, unmet goals, interventions not specified within a critical pathway
146
health care information technology is used to
enhance quality and efficancy of care
147
health care information systems are composed of two types
a clinical info system and an administrative informations system
148
clinical information system (CIS)
example: computerized provider order entry (CPOE)
149
nursing clinical information systems
two designs: nursing model and critical pathway
advantages: better information access, better documentation quality, reduced errors of omission, reduced hospital costs, increased nurse job satisfaction, clinical database development
150
clinical decision support systems (CDSS)
aids and supports clinical decision making
151
nursing informatics
- speciality area of practice
- integrates nursing science, computer science, and information science
- informatics competencies for nursing graduates
152
environmental safety
basic human needs like
oxygen
nutrition
temperature
153
common environmental hazards
MVA
poison
falls
fire
disasters
154
transmission of pathogens
immunizations
155
factors influencing patient safety
- devlopmental stages and risks
- individual risk factors (workplace, lifestyle, mobility, sensory impairment, economic resources, lack of safety awareness)
- risk in health care agencies (procedure-related accidents, equipment related accidents, chemical exposure, falls, workplace safety)
156
assessment
- through pt eyes
- nursing history and exam
- psychological and cultural background
- health care environment (risk for medical error and disasters)
- pt home environment (risk for falls, psychosocial resources)
157
outcomes is reliant upon
patient participation
158
setting priorities
select priorities based on risk and patient characteristics
159
teamwork and collaboration
communication is essential
160
health promotion
- developmental interventions
- environmental interventions (fall safety within home)
- general preventative measures
161
acute and restorative care
- fall prevention
- restraints
- side rails
- fires
- electrical hazards
- seizures
- disasters
- preventing workplace violence
162
evaluation
through pt eyes:
are pt expectations met
are family's expectations met
163
patient outcomes evaluation
monitor care by HCT
measure outcomes
continually assess needs for additional support
164
safety guidelines for nursing skills
- anticipate a pt fall risk when choosing fall prevention strategies
- involve patients and families in the selection of fall prevention strategies
- always try restraint alternatives before using a restraint
- implement fall prevention protocols and provide pt and family education
165
