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| A national organization that offers peer evaluation for accreditation every 3 years for all types of U.S. health care agencies that meet their standards. |
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National Patient Safety Goals (NPSGs) |
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| These goals require health care organizations to focus on specific priority safety practices, many of which involve nursing care. |
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| Refers not just to physician incidents but to errors caused by ALL members of the health care team or system that lead to patient injury or death. |
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| Save lives and decease the risk for harm by providing care to patients before a respiratory or cardiac arrest occurs. |
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| physician who specializes in critical care |
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| Family practitioner or internist employed by the hospital |
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| the medical-surgical nurse recognizes "the patient or designee as the source of control and full parter in providing compassionate and coordinated care based on respect for the patient's preferences, values, and needs" |
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| self-determination/self-management |
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| patients are treated as autonomous individuals capable of making informed decisions about their care |
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| emphasizes the importance of preventing harm and ensuring the patient's well-being. |
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| refers to equality; that all patients should be treated equally and fairly. |
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| three essential ethical principles: |
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1. self-determination
2. beneficience
3. social justice |
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| Entails planning, implementing, and evaluating patient care together using an interdisciplinary plan of care. |
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| process is to provide quality and cost-effective services and resources to achieve positive patient outcomes. in collaboration with the nurse, the CM coordinates inpatient and community-based care before discharge from a hospital or facility. |
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| What is SBAR and what does SBAR stand for? |
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Definition
SBAR is a formal method of communication between two members of the healthcare team.
Situation: describe what is happening at the time to require this communication.
Background: explain any relevant background information that relates to the situation.
Assessment: provide an analysis of the problem or patient need based on assessment data.
Recommendations: state what is needed or what the desired outcome is. |
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| the process of transferring to a competent person the authority to perform a selected nursing task or activity in a selected patient care situation. |
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| guidance or direction, evaluation, and follow-up by a nurse to ensure that the task or activity is performed appropriately. |
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| evidence-based practice (EBP) |
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| the integration of the best current evidence to make decisions about patient care. |
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| nurses are expected "to use data to monitor the outcomes of care processes and use improvement methods to design and test changes to continuously improve the quality and safety of health care systems." |
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| involves using information and technology to communicate, manage knowledge, mitigate error, and support decision-making |
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| requires a broad knowledge base to meet the needs of adult patients in a variety of settings across the continuum. |
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| the vital role of the nurse? |
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| the nurse is an advocate to empower patients and their families to have control over their health care. |
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6 Core competencies for health care professionals: |
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Definition
1. patient-centered practice
2. teamwork and collaboration
3. evidence-based practice
4. quality improvement
5. informatics
6. safety |
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| The steps of EBP Practice |
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Definition
1. Asking "burning" clinical questions
2. Finding the very best evidence to try to answer those questions
3. critically appraising and synthesizing the relevant evidence
4. making recommendations for practice improvement
5. implementing accepted recommendations
6. evaluating outcomes |
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Definition
focuses on the meanings and interpretations of human phenomena or experience of people and usually analyzes the content of what a person says during an interview or what a researcher observes
ex/ What is the experience of having cancer like for young adults? |
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Definition
asks about the relationship between or among defined, measurable phenomena and includes statistical analysis of information that is collected to answer a question.
ex/ what is the effect of using a new assessment tool to predict the likelihood of falling to frequency and severity of falls in patients undergoing hip replacement? |
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| What does PICO(T) stand for? |
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Definition
Population=the specific group of patients to whom the question applies
Intervention=pertains to the therapeutic effectiveness of a new treatment and may include 1)exposure to disease/harm 2)prognostic factor 3)risk behavior/factor
Comparison=may be either the standard or current treatment or may be another intervention with which the innovative practice is compared.
Outcome=the measurable and desired outcomes of your practice,innovation, diagnosis, or prevention intervention
(Time = added on when appropriate) |
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Definition
Major purpose is to help health care professionals use evidence to improve patient outcomes.
Important aspects of the current model:
- triggers that lead to clinical questions
- assessment of whether these questions are priorities for the health care organization
- focus on forming a team to develop an EBP initiative
- general overview or steps for deciding about whether to implement and then adopt a change in practice
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| Reavy and Tavernier Model |
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Definition
| Reavy and Tavernier developed a model and process to implement EBP that uses concepts from previously developed models |
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Definition
The Advancing Research and Clinical Practice through Close Collaboration model of EBP- main components:
1.organizational assessment & readiness to implement EBP
2.Idenfication of strengths and barries to EBP implementation
3. Development and use of EBP mentors
4. Measurement of nurse, system, and patient outcomes |
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Definition
When making changes based on findings from the literature, use PDSA cycles to test the changes on a small scale.
Plan= first step in introducing a practice change
Do= the action-oriented phase of the process
Study= refers to the review and analysis of data collected during the "do" phase of the cycle
Analysis= analysis and evaluation of results from the small test to guide decisions about how to proceed.
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| addresses the relationship between a person's beliefs and behaviors |
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| the person's ideas, convictions, and attitudes about health and illness |
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Describes the multidimensional nature of people as they interact within their environment to pursue health.
This model focuses on 3 areas:
1. individual charachteristics and experiences
2. behavior-specific cognitions and affect
3. behavioral outcomes |
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| moslow's hierachy of needs |
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Definition
Highest - lowest:
self actualization
self esteem
love and belonging needs
safety and security
physiological
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| generally a comprehensive view of the person as a biopsychosocial and spiritual being |
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| Internal variables that influence health beliefs and practices: (4) |
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1. developmental stage
2. intellectual background
3. emotional factors
4. spiritual factors
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External variables that influence health beliefs and practices:
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Definition
1. Family practices
2. socioeconomic factors
3. cultural background |
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| active strategies of health promotion |
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Definition
when individuals adopt specific programs
ex/ weight reduction and smoking cessation programs |
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| passive strategies of health promotion |
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Definition
individuals gain from the activities of others without acting themselves
ex/ the city puts fluoride in the municipal drinking water or milk manufacturers fortify homogenized milk with vitamin D |
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| activities such as routine exercise and good nutrition, help patients maintain or enhance their present levels of health and reduce their risks for developing certain diseases. |
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| teaches people how to care for themselves in a healthy way and includes topics such as physical awareness, stress management, and self-responsibility |
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| activities such as immunization programs, protect patients from actual or potential threats to health. |
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| it precedes disease or dysfunction and applies to patients considered physically and emotionally healthy. |
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| focuses on people who are experiencing health problems or illnesses and who are at risk for developing complications or worsening conditions. |
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| occurs when a defect or disability is permanent, irreversible, and stabilized. |
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| any situation, habit, environmental condition, physiological condition, or other variable that increases the vulnerability of an individual or a group to an illness or accident. |
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| usually short term and severe. the symptoms appear abruptly, are intense, and often subside after a relatively short period. |
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| usually lasts longer than 6 months. patients fluctuate between maximal functioning and serious health relapses that are sometimes life threatening. |
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| these behaviors affect how people monitor their bodies, define and interpret their symptoms, take remedial actions, and use the health care system. |
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| based on judicial decisions or case law precedent |
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| rules codified by legislative bodies of government |
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| examples of statutes enacted by state legislatures to regulate the practice of nursing |
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| crime that while injurious, does not inflict serious harm |
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| a serious offense that results in significant harm to another person or to society in general |
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| civil wrongful acts or omissions against a person or person's property that are compensated by awarding monetary damage to the individual whose rights have been violated |
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| the failure to use that degree of care that a reasonable nurse would use under the same or similar circumstances. |
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preventable errors
ex/ may include falls, UTIs, pressure ulcers |
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| a patient's agreement to allow something to happen, such as surgery, based on a full disclosure of the risks, benefits, alternatives, and consequences of refusal. |
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| refers to the fundamental agreement to do no harm. |
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| defines actions as right or wrong based on "right-making charachteristics" like truth and jsutic |
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| systematically developed statements about a plan of care for a specific set of clinical circumstances involving a specific patient population. |
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| nursing-sensitive outcome |
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| focuses on how nursing interventions affect patients and offers a measure of nursing's contribution to patient care. |
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| 5 Components of the nursing process: |
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| Assessment Diagnosis Planning Implementation Evaluation |
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| a professional nurse's approach to identifying, diagnosing, and treating human responses to health and illness |
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| the deliberate and systematic collection of data about a patient |
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| includes information about a patient's physical and developemental status, emotional health, social practices and resources, goals, values, lifestyle, and expectations about the health care system. |
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| your patient's verbal descriptions of their health problems |
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| observations or measurements of a patient's health status |
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| prompts patients to describe a situation in MORE than one or two words. |
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| is the practice of giving positive comments such as "all right", "go on", or "uh-huh" to the speaker. |
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| limit the patient's answers to one or two words such as "yes" or "no". |
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| a clinical judgement about individual, family, or community responses to actual and potential health problems or life processes. |
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| the identification of a disease condition based on an evaluation of physical signs, symptoms, history, and diagnostic tests and procedures. |
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| developed a model for organizing nursing diagnoses for documentation, auditing, and communication purposes. |
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| involves setting priorities, identifying patient-centered goals and expected outcomes, and prescribing nursing interventions |
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| the performance of nursing interventions necessary for achieving the goals and expected outcomes of nursing care. |
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crucial to deciding whether, after interventions have been delivered, a patient's condition or well-being improves |
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| HAZARD is anything in the clinical environment that poses a risk for harm to a patient or provider |
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| The process for an EB question or practice: |
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Definition
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¡Step 1: Formulating a well-built question
§“Burning” question
§PICO format
¡Step 2: Identifying articles and other evidence-based resources that answer the question (lit review)
¡Step 3: Critically appraising the evidence to assess its validity
¡Step 4: Applying the evidence
¡Step 5: Re-evaluating the application of evidence and areas for improvement
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| Theoretical means of understanding a concept or idea |
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| “state of complete physical, mental, and social well-being and not merely the absence of disease and infirmity” (WHO) |
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| A,B,Cs for Prioritizing Nursing Care |
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Definition
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•A – Airway
•B – Breathing
•C – Circulation
•D – Danger
•E – Education
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Definition
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•Limitation on freedom or autonomy for the individual’s “own good”.
•In healthcare, treating a person or persons without their consent, usually citing diminished capacity (either permanent or temporary)
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•Ethical justification for actions that have both helpful and harmful aspects.
•Argues that even though consequences may be the same (example, death of a patient), the intent can make the action ethically acceptable (murder vs terminal sedation)
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| C.O.D.E - The key to taking action in a dilemma: |
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•Courage: Determine if moral courage is needed to address the situation.
•Obligation to honor: Take a time out to reflect on ethical obligations.
•Danger management: Use cognitive approaches to handle your fear (deep breathing)
•Expression: Express your beliefs and take action through assertiveness.
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