Topic 6 Flashcards

(47 cards)

1
Q

what are the characteristics of a therapeutic relationship?

A

client centered
partnership
professional boundaries/violations
involvement/active participation
use of self (authenticity, presence, self awareness)

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2
Q

client centered

A

includes clients individuals preferences, values, beliefs and needs

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3
Q

partnership

A

honors clients right to self-determination, giving client and family maximum control over health care decisions- advocate for client and encourage independence

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4
Q

professional boundaries

A

protect function integrity of alliance between nurse and client

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5
Q

violations

A

take advantage of clients vulnerability and represent a conflict of interest

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6
Q

involvement/ active participation

A

degree of nurses attachment and active participation in clients care

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7
Q

over involvement

A

loss of essential objectivity need to support client meeting health goals

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8
Q

authenticity

A

requires admitting mistakes and recognizing vulnerabilities

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9
Q

presence

A

in the moment

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10
Q

self-awareness

A

reflective process seeking to understanding ones values, feelings, attitude, motivations, strengths and limitations

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11
Q

What is effective communication?

A

a 2 way exchange of information among clients and health care providers, patients and families ensuring that the expectations and responsibilities of all care are clearly understood

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12
Q

who created the original 5 c’s

A

the Joint Commission

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13
Q

6 C’s

A

clear
concise
concrete
complete
courteous
correct

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14
Q

professional standards for effective communication are set by which organizations?

A

Institute of Medicine (IOM)
the Joint Commission (TJC)
World Health Organization (WHO)
International Council of Nurses (ICN)

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15
Q

what did the IOM create and its goals in regards to effective communication

A

5 reports for safety and equality of health care
accurate, complete communication is one of its goals

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16
Q

what did the TJC create and its goals in regards to effective communication

A

regulates hospitals and evaluates safety fro accreditation
effective communication (6 C’s)

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17
Q

what did the WHO create and its goals in regards to effective communication

A

offered 9 solutions for increased health care safety
includes correctly identifying the patient and better communication during patient hand off

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18
Q

what did the ICN create and its goals in regards to effective communication

A

set expectations for communication in nursing goals including “ensuring confidentiality”

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19
Q

the ANA scope and standard of practice model of professional nursing practice regulation includes…

A

quality of care
safety
evidence (EBP)

20
Q

Agency for Healthcare Research and Quality (AHRQ)

A

The branch of the US Public Health Service that is involved in patient safety by funding research and compiling evidence to publish best evidence-based standards of practice

21
Q

American Association of Colleges of Nursing (AACN)

A

makes recommendations for nursing curricula- standard hand off report (SBAR)

22
Q

what are the safety incidences? (where mistakes are made)

A

miscommunication
errors are usually system problems (multiple smaller events)
fatigue and hand off (up to 70% preventable)
high financial and human cost
under reporting med errors (90% go unreported)

23
Q

what are some examples of unprofessional nursing conduct?

A
  • breaching client confidentiality
  • assuming nursing responsibility for actions without having sufficient preparation
  • delegating care to unlicensed personnel, which could lead to client injury
  • following a doctor order that would result in client harm
  • failing to assess, report or document changes in client health status
  • falsifying records
  • failing to obtain informed consent
  • failure to question physicians orders, if not clear
  • failure to provide required health teaching
  • failure to provide for clients safety (like not putting up bed rails)
24
Q

what are some ways to ensure safer practices?

A

use of checklist
timely documentation
standardized tool for better communication (SBAR)
technology oriented solutions (electronic IDs, barcoding tech)
avoid work arounds
understand role relationships
EBP research and promote safer policies/procedures

25
safer practices from team strategies
transforming care at bedside interdisciplinary rounds huddles change of shift reports done at bedside call outs and time outs (surgery) TeamSTEPPS "IPASStheBATON" resource management with other team members to promote concise effective communication communicate with other HCP to creates a team culture of collaboration and cooperation
26
SBAR
Situation Background Assessment Recommendation
27
situation
patient name, age, room # attending and consulting physical involved in care diagnosis and admission date description of pt. current situation
28
(SBAR) background
pertinent procedures/ test completed allergies, code, most recent VS, BS, labs basically head to toe assessment current meds and comorbidities
29
assessment
any changes in respiratory status most important (medical) any changes in mental status (psych) what happened during todays shift last pain med given any meds held/rationale
30
recommendation
suggestion of actions to be taken (plan of care, what patient needs, procedures/tests pending or to be scheduled) any recommendation for discharge
31
at the end of SBAR what should happen
ask receiving nurse if they have any questions
32
therapeutic communication
-the purposeful use of communication to build and maintain helping relationships with the client, families, and significant others -client centered: not social or reciprocal -purposeful, planned, and goal-directed
33
characteristics of professional conversation include
specific rules and boundaries relates to function and privacy define therapeutic goals pt. centered individualized strategies related to health related goals
34
nonverbal communication
tone of voice, inflections, facial expressional, body language, active listening (maintain eye contact, leaning forward, nodding, etc.)
35
TeamSTEPPS model
emphasizes improving patient outcomes by improving communication and using evidence based practices clear brief timely complete
36
the teamSTEPPS "I PASS the BATON" is used for..
more effective communication between health care teams and handoffs
37
I PASS the BATON
Introduction Patient Assessment Situation Safety Concerns Background Actions Timing Ownership Next
38
introduction
introduce self and role
39
assessment (I PASS the BATON)
chief complaint, VS, symptoms, diagnosis
40
patient
patient name, identifiers, sex, location
41
(IPASSBATON) situation
current status, level of certainty, recent changes, response to treatment
42
safety concerns
critical labs, allergies, alerts (falls)
43
(BATON) background
comorbidities, previous episodes, current meds, family history
44
actions
what actions taken and why
45
timing
level of urgency, explicit timing and priorities
46
ownership
state who is resposible
47
next
state the plan: what will happen next, any anticipated changes