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What is the definition of nursing?
Comes from the latin word nutrix-to nourish
nursing is both an art and a science
- ANA-social policy statement
- -a contract b/t a client and a nurse
client is the central focus of all definitions
What are some important contributions of Florence Nightingale?
- Founder of modern nursing
- est first nursing philosophy based on health maintenance and restoration
- firs practicing nurse epidemiologist
- first nurse researcher
- organized first school of nursing
- nursing is distinct from medicine
What are two influences on today's health care delivery system?
- 1. rising cost of healthcare
- -nurse's responsibility to privde high quality healthcare in an efficient and economically sound manner
- --> by prioritizing, educating patients, organizing time
- 2. evidence based practice
- -consumers are more informed and expect more
- -nurse provide safe, effective care using evidence based practice
What are the primary characteristics of a profession?
- extended education and basic liberal foundation
- theoretical body of knowledge
- provides a specific service
- members have autonomy
- profession has a code of ethics for practice
How is nursing a profession and discipline?
- practice in many different settings
- develop a specific body of knowledge
- conduct and publish nursing research
- recognize role in promoting health
- use nursing knowledge as base for nursing practice
What are the professional roles of a nurse?
What are the advanced practice areas of nursing?
- clinical nurse specialist
- nurse practitioner
- nurse anesthetist
- nurse midwife
What are the expanded educational and career roles of nurses?
- nurse administrator
- nurse researcher
- nurse entrepreneur
- nurse educator
What are Benner's stages of nursing proficiency?
- 1. Novice
- 2. Advanced beginner
- 3. competent (3yrs of experience needed!)
- 4. proficient
- 5. expert
What is the purpose of nurse practice acts?
- define legal scope of nursing practice
- exclude untrained or unlicensed people from practicing nursing
- create a state board of nursing
- make and enforce rules and regulationsdefine important terms and activities in nursing
- provide legal requirements and titles for RNs and LPNs
- Establish criteria for education and licensure of nurses
What are the responsibilities of a professional nurse?
- obtaining and maintaining specific knowledge and skills
- to provide care and comfort
- emphasize health promotion and illness prevention
What is the importance of nursing theories?
- a perspective to view client situations
- a way to organize data
- a method to analyze and interpret information
What is the goal of nursing knowledge?
to explain the practice of nursing as different and distinct from the practice of medicine, psychology, and other health care disciplines
What are the 6 steps of evidence based practice?
- 1. ask the clinical question
- 2. collect the best evidence
- 3. critique the evidence
- 4. integrate the evidence
- 5. evaluate the practice decision or change
- 6. share the outcomes of EBP changes with others
What is the goal of Roy's Adaptation theory?
- Goal of nursing is to help a person adapt to change
- -need for nursing care arises when a person cannot adapt to environmental demands
- -views the client as an adaptive system
According to Roy's theory, what demands does a person need to adapt to?
- meeting basic physiological needs
- developing a positive self concept
- performing social roles
- achieving a balance between dependence and independence
What was the focus of Hildegard Peplau's theory?
- Nurse-client relationship
- nursing is therapeutic
- fundamental to psychiatric nursing
What are the 6 ethical principles and their definitions?
Autonomy: refers to a person's independence, right to determine course of action, keeps the client in charge of their health decisions
Beneficence: "do good" for the client over self
Nonmaleficence: "do no harm"-no abuse, only competent actions
Fidelity: agreement to keep promises, faithfulness
What are the basic principles of the ANAs code of ethics?
accountability, responsibility, advocacy, confidentiality, and veracity
How should you process an ethical dilemma?
- 1. Is this an ethical dilemma?
- 2. Gather all data
- 3. explore your own values or beliefs
- 4. verbalize your problem
- 5. list potential solutions, courses of action
- 6. negotiate the outcome
- 7. evaluate the action
What are resources for solving ethical dilemmas?
- 1. Ethics committee
- 2. Multidisciplinary committees
- 3. The processing of ethical dilemmas
What are some challenges facing health care today?
- reducing health care cost while maintaining quality
- improving access and coverage for more people
- encouraging healthy behaviors
- earlier hospital discharges result in more clients needing extended care
What are the levels of healthcare?
What is the role of health care professionals in health promotion?
- assess health status
- identifies health problems
- develops, coordinates and implements a specialized plan of care for each patient
What is the role of Professional Standards Review Organizations (PSRO)?
created to review the quality, quantity and cost of hospital care provided through medicare and medicaid
What is the role of Utilization review committees?
review admissions, diagnostic testing, and treatments provided by physicians who cared for client receiving medicare
What are two federally funded health programs
medicare and medicaid
What is Medicare?
national health insurance program for adults over 65
- Part A: provides insurance toward hospitalization, home care, and hospice care
- Part B: voluntary, provides partial coverage of outpatient and physician services
- Part D: voluntary prescription drug plan
Most pay monthly premium for parts B and D
What is medicaid?
federal public assistance program paid out of general taxes to people who require financial assitance
What is CHIP?
- federal program that provides insurance for children
- coverage includes visits to primary health care providers, prescription medicines and hospitilization
What is the Preferred Provider Organization?
- consists of a group of providers and perhaps a health care agency
- provides an insurance company or employer with a health service at a discounted rate
- provides clients with a choice of health care providers and services
- tends to be slightly more expensive than HMO plan
What is the health maintenance organization?
- provides health maintenance and treatment services to voluntary enrollees
- fee is set without regard to the amount ot kind of service
- emphasizes client wellness
- clients limited in ability to select health care providers and services
- available services at reduced and predetermined cost to the client
What is the Nurses role in healthcare reform?
- stay informed about current issues and legislation
- write members of congress to support legislation to improve nursing care
- belong to nursing organizations
- document the outcomes of nursing care
- be a leader in nursing and consumer groups
- advocate for the right of all for healthcare
What is the reason for accreditation (Ex: hospital)?
- To demonstrate quality and safety
- to evaluate performance, identify problems, and develop solutions
- must be accredited to receive federal funding
What are the goals of healthy people 2020?
- increase life expectancy and quality of life
- to eliminate health disparities through improved deliver of health care services
What are some vulnerable populations?
- poor and homeless
- substance abusers
- mentally ill
- older adults
What are the essential components of home healthcare?
- client and family
- heath care professionals from various disciplines
- client goals are to reach maximum independence and health status
What are the key qualities of home healthcare nurses?
- knowledgeable and skilled in their practice
- able to make decisions independently
- able to remain accountable
What are the key components of hospice care?
Hospice: comprehensive and coordinated care for people with limited life expectancy
Palliative care: prevents and relieves suffering by early assessment and treatment of pain and other physical, psycho-social, and spiritual needs
Bereavement care: continuation of care for the family following the death of a client
What makes up the framework of a health care delivery system?
- managed health care
- case management
- primary healthcare
What are Managed Care Systems?
- controls cost of care while maintaining wuality of care
- manager of "gatekeeper" plans and monitors the care
- limits choice of care providers
- required approval for specialty care
What is the role of a case manager?
- coordinator of care
- controls cost
- improves access to healthcare