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Transitions 2 Flashcards

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1
Q

system of principles that govern the actions of the nurse in relation to patients, families other health care providers, policymakers and society.

A

ethics

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2
Q

implicit standards and values for a profession.

A

code of ethics
examples: american nurses association code of ethics and international council of nurses code of nurses

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3
Q

interdisciplinary field within health care that has evolved with modern medicine to address questions that arise as science and technology produce new ways of knowing

A

bioethics

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4
Q

dilemma of choice between health care alternatives due to lack of clear sense of right and wrong

A

bioethical dilemma

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5
Q

with the civil rights afforded to all member of US society, health care professionals are afforded the right to practice their own convictions about what is right and ethical care (specifically abortion and euthanasia)

A

Right of Conscience

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6
Q

system of principles by which a person can determine what should and should not be done

A

ethical theory

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7
Q

action is right if it leads to the greatest amount of good consequences and least amount of bad ones; greatest ratio of benefit to harm for all persons involved. Strongest approach for bioethical decision making

A

Utilitarianism

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8
Q

a decision is right only if it conforms to an overriding moral duty and wrong if it violate moral duty.

A

Deontology

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9
Q

personal belief that acts as a guide to behavior

A

value

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10
Q

framework on which actions are based

A

value system

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11
Q

process of examining the values one holds and how those values function as part of a whole

A

values clarification

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12
Q

forming a worldview and value system through an evolving, continuous process

A

moral development

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13
Q

first nurse leader to describe the role of values clarification

A

Diane Ustal

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14
Q

Moral Development: no concept of right and wrong.

A

Infants

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15
Q

Moral Development: good behavior rewarded, bad behavior punished. Make choices based on understanding of good and bad

A

Toddlers

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16
Q

Moral Development: they question existing moral values and their relevance to society. Become aware of contradictions in adults; values systems

A

adolescents

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17
Q

Moral Development: attempts to make sense of contradictions. Learns own moral and values. Makes choices based on own set of principles

A

adults

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18
Q

At what stage is human life first able to integrate values based on right and wrong?

A

Toddler

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19
Q

establish common ground among nurse, patient, family and other health care professionals and society; provide an analytical framework by which moral problems can be evaluated

A

Purpose of ethical principles

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20
Q

people are free to form their own judgements and actions as long as they do not infringe on the autonomous acts of others

A

Autonomy

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21
Q

to promote good, kindness, and charity

A

Beneficence

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22
Q

duty to not inflict harm

A

Nonmaleficence

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23
Q

principle of truth telling. accurate precise information delivered in an honest, respectful manner

A

Veracity

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24
Q

nurse assumes responsibility for patient harm or injury resulting from negligent acts

A

Personal liability

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25
direct violation of person’s legal rights; proving nurse breached duty or was negligent is not necessary
Intentional torts in nursing practice
26
What are two types of intentional torts in nursing practice?
Negligence and Malpractice
27
negligent act is common knowledge, " the thing that speaks for itself;" expert nurse witness not required. Example: leaving foreign bodies in patient during surgery
Res Ispa Loquitor
28
reckless act made of conscious decision disregarding patient welfare
Gross negligence
29
act is so reckless that it results in serious injury or death of patient
Criminal negligence
30
defamation of character
Libel/slander
31
use of restraints
false imprisonment
32
What is an example of defenses against negligence claims?
RN may never use the defense of "following physicians orders"
33
time limits within which a person may initiate lawsuit
Statutes of Limitation in Malpractice
34
studies confirm revealing mistakes to patient and family result in less severe ramifications
Transparency and Disclosure Error
35
What evidence is needed for an intentional tort?
- Nurse owed duty of care - nurse breached duty - patient suffered actual harm or damage - causal connection is established between standards of care and patient injury
36
What are some common allegations of negligence?
- Failure to ensure patient safety. - Improper treatment - Failure to monitor patient - Failure to report significant findings - Medication errors - Failure to follow agency policies and procedures
37
right to refuse extraordinary medical treatment without hope for recovery
advanced directives
38
formal document of patient wishes
Living Will
39
written by physician on the basis of patient directive
DNR
40
document of patient authorizing person who will make day-to-day and end-of-life decisions when patient incompetent of doing so themselves
Durable power of attorney
41
What are some examples of the law and patient rights
- advance directives - DNR - Durable power of attorney - Informed consent - Right to refuse treatment - AMA - use of physical restraints
42
Law established by act of legislature and signed by the executive
Statutory Law
43
acts passed by Congress and signed by the president
Federal statutory law
44
passed by state legislature and signed by state governor
State statutory law
45
laws of mandatory reporting of specific health problems and suspected/confirmed abuse
Mandatory Reporting
46
someone who reports false claims or fraud
Whistleblower
47
establishes that it is offensive and are punishable by fine or imprisonment
Federal False Claims Act
48
Emergency Medical treatment and active labor law
EMTALA
49
- Prohibits refusal of care to indigent (poor or needy) or uninsured patients - Prohibits transfer of unstable patients from one facility to another
EMTALA
50
prohibits discrimination against persons with disabilities by removing barriers that may prevent equal opportunity to person with disabilities
American with Disabilities Act (ADA)
51
enforces that it is the patient who should decide to accept or decline suggested treatment or care
Patient Self Determination Act
52
national standards that protect sensitive healthcare information from being disclosed without patient consent or knowledge
HIPAA: Health Insurance Portability and Accountability Act
53
establishes a voluntary reporting system designed to enhance data available to assess and resolve patient safety and health care quality issues
Patient Safety and Quality Improvement Act
54
What are the Five Rights of Delegation?
1. Right task 2. Right circumstances 3. Right person 4. Right direction/communication 5. Right supervision and evaluation
55
Which would have the highest priority when determining who to delegate task?
Credentials of person to whom task is delegated
56
Transfer of responsibility for an activity from one individual to another while retaining responsibility for the activity
Delegation
57
What cannot be delegated by the nurse?
Initial assessment, evaluation, teaching, and nursing judgement
58
distribution of work that each staff member is responsible for during given work period
assignment
59
ensuring an adequate number and mix of team members to meet patient needs and provide safe quality care
staffing
60
RN is responsible for planning, organizing, and performing all patient care during assigned shift. Common in critical care and PACU
Total patient care
61
Staff members assigned to certain tasks for a group of patients rather than care for specific patients. Common in OR
Functional Nursing
62
RN functions as team leader and coordinates care for small group of patients
Team Nursing
63
modification of team nursing. Patient unit divided into modules, and team member assigned to consistent geographic locations
Modular Nursing
64
RN assumes 24 hours responsibility for planning directing, and evaluating patient care from admission to discharge. Total patient care while on duty. Ex: home health, hospice, long-term care
Primary Nursing
65
The nursing shortage escalates, and certain geographic areas must institute delivery models that require fewer numbers of registered nurses. Which type of nursing delivery models would be appropriate?
Team nursing and Functional nursing
66
providing care that is respectful of and responsive to individual patient preferences, needs, and values, and ensuring that patient values guide all clinical decisions.
Patient-Centered Care
67
document details how financial resources allocated to ensure organizational ability to conduct daily business and achieve strategic goals; itemizes predicted expenses and predicted revenues for given period of time
Budget
68
What are the four stages of budgeting?
Planning, Coordinating and Communicating, Monitoring, and Evaluating
69
What stage of budgeting is this? - Decide goals for specified period and identify resources to achieve said goals - Predict revenues and expenses - Allows managers to answer questions like salary and how new services affect the organization - Most often developed for 1 year period
Planning
70
What stage of budgeting is this? - Different groups within organization come together to discuss resources necessary to accomplish goals of unit - Opportunity to discuss concerns and resolve issues of various parts of the organization
Coordinating and Communicating
71
What stage of budgeting is this? - Nurse manager - Compares actual performance against expected/budgeted performance to measure effectiveness of budget - *Variance: difference between planed and actual results
Monitoring
72
What stage of budgeting is this? - Budget results determine staff bonus structure - Budget results also used to determine manager’s overall success of achieving set goals, including assessing nursing overtime cost and supply use - Lack of staff ownership of and involvement in unit operation leads to problems for nurse manager
Evaluating
73
What are the three types of Budgets?
1. Operational Budget 2. Labor Budget 3. Capital Budget
74
What type of Budget is this? - Revenues and expenses necessary to operate the unit - Salaries, utilities, equipment maintenance, supplies, etc - Revenue from health insurance companies, medicare/Medicaid, out of pocket payments, other govt programs or grants
Operational Budget
75
What type of budget is this? - Subset of operational budget - Detailed documentation of salaries, wages and benefits - Always the LARGEST expense of operational budget, 55-65% of total budget - Major concern is balancing patient acuity with RN-pt ratio
Labor Budget
76
What type of Budget is this? - Funds for construction projects and major equipment, and long term investments - Multi-year planning
Capital Budget
77
What are the two types of Budgeting?
Incremental and Zero-Based budgeting
78
What type of budgeting is this? - Most commonly used budget method. - Takes current revenue and expenses and assumes small inflationary/growth factor - Strength is its simplicity
Incremental Budgeting
79
What type of budgeting is this? - Developed as though budget being used for the first time - is not based on revenue and expenditures of the prior year, start from scratch each year
Zero-Based Budgeting
80
A nurse manager is preparing the budget for the renal dialysis unit for the new fiscal year and predicts a 10% daily census increase with a corresponding increase in revenues and expenditures for the upcoming year. The nurse manager is using which budget method?
Incremental Budgeting
81
The first step in the budget development process is too?
identify the organization’s strategic goals and objectives
82
basic measure of product or service being produced
Service unit or unit-of-service (types of costs)
83
directly related to production of the unit-of-service
Direct costs (types of costs)
84
operating expenses but not directly related to providing the unit-of-service
Indirect costs or overhead (types of costs)
85
total of all costs associated with a unit-of-service; includes direct and indirect costs
Full Cost (types of costs)
86
do not change as unit-of-service volume changes
Fixed costs (types of costs)
87
vary directly with change in volume of units of service
Variable costs (types of costs)

Transitions 2 (1 decks)

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