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2013-11-21 09:06:31

Transition to the Registered Professional Nurse Role
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  1. Who focused on hygiene and sanitation and believed strongly in continuing education?
    Florence Nightingale
  2. Who organized the American Red cross and was responsible for relief operations during the Civil War?
    Clara Barton
  3. Who was the nurse who became responsible for construction of state psychiatric hospitals?
    Dorothea Dix
  4. Conductor of underground railroad who assisted Clara Barton to tend to wounded soldiers during the Civil War.
    Harriet Ross Tubman
  5. Born into slavery, nursed Union soldiers, worked to improve sanitary conditions, got food and clothing for black soldiers
    Sojourner Truth
  6. Radical changes in nursing education, reduced student work day from 10 to 8 and eliminated FREE private duty services
    Isabel Hampton Robb
  7. Created FNS Frontier Nursing Service- 1st midwifery training school
    Mary Breckinridge
  8. did a study which resulted in establishment of associate degree nursing education
    Mildred Montag
  9. Nursing leader and women's right activist giving women the right to vote- also a key figure in community nursing and introduced nursing in schools
    Lavinia Dock
  10. Early theorist who taught "a patient is a person who requires help toward independence"
    Virginia Henderson
  11. America's first African American Nurse
    Mary Mahoney
  12. a psychiatric nurse- described Nurse- Client relationships
    Hildegard Peplau
  13. America's first trained nurse- also key figure in development of nursing education, moved from hosp to hosp an improvement campaign
    Melinda Ann (Linda) Richards
  14. opened FIRST birth control clinic with her sister in Brooklyn
    Margaret Sanger
  15. Founder of public health nursing - established a neighborhood nursing service in NYC
    Lillian Wald
  16. Religion- *R* Protestant Churches- women subordinate to men- nurse most menial of servants
    The Reformation
  17. Earliest counterpart to community health nurses- worldly items were of no concern to nurses, nurses required strict obedience, devotion, and setting aside themselves
    Order of the Deaconesses
  18. Roman Catholic society - sister nurses nursed cholera pt's Mercy Hospitals
    Sisters of Mercy
  19. Sisters that visited pt's in homes, hosp, and poorhouses and asylums. Developed educational programs for Nurses
    Sisters of Charity
  20. Earliest organization for Men in Nursing. Raised standards of education, culture. Care of the sick was above others duties of Monk. Emphasized Bathing
    Monastic Orders
  21. Founded during Crusades- staffed 2 hospitals in Jerusalem
    Military Nursing Orders
  22. *Military* *M* Military Nursing Service formed, Florence Nightingale cleaned up the hosp, orderlies scrubbed often, camp followers scrubbed clothes, and vermin were under control
    Crimean War
  23. Philadelphia Dispensary was formed for free pt care, homes and barns were makeshift hosp, women left during war were there to care for sick and injured Controlled disease and smallpox vaccination was given
    American Revolution
  24. Public saw the need for trained nurses, Clara Barton, Harriet Tubman, Sojourner Truth tended to the soldiers
    American Civil War
  25. Nursing schools were already established and Isabel Robb developed a plan for managing nurses
    Spanish-American War and the Boer War
  26. Increased demand for nurses, Army School of Nursing - nurses needed to be unmarried and of good moral character
    World War 1
  27. Bolton Act created the US Cadet Nurse Corps. Nurses got full military commission, post war- Hill Burton Act
    World War 2
  28. MASH units
    Korean War and Vietnam conflicts
  29. Care focused on soldiers and victims of war
    Gulf War- Afghanistan- Iraq
  30. *Nursing Organizations Concerns itself with social and economic welfare of nurses, the role of the nurse, the nursing organizations and their their governing bodies
    ICN- International Council of Nurses
  31. For RN'S- Is involved in all issues that nursing has confronted with Legislation, Collective bargaining, advancement of profession
    ANA- American Nurses Association
  32. Was formed to assist collegiate schools of nursing to improve higher education for nursing.
    AACN- American Association of Colleges of Nursing
  33. Was formed to provide accreditation
    CCNE- Commission on Collegiate Nursing Education
  34. Provides a legal regulatory bodies of all states to act together re: boards, exams, licensing
    NCSBN- National Council of State Boards of Nursing
  35. First Nursing Organization in the US. 5 Goals- nursing education development and improvement, faculty development, nursing ed research, data collection, assessment & evaluation
    NLN- National League for Nursing
  36. Baccalaureate program honorary organization for exceptional standards
    Sigma Theta Tau (STTI)
  37. For those who have made significant contributions to nursing- honorary part of ANA
    AAN- American Academy of Nursing
  38. Student nursing organization
    NSNA- National Student Nurses' Association
  39. 4 Purposes to 1. Speak for associate degree nursing education and practice 2. Reinforce the value of that degree 3. Maintain endorsement for grads with associate degree, 4. retain the RN exam for associate degree grads
    NOADN- National Organization For The Associate Degree Nursing
  40. Organization for nurses who design, facilitate, and manage care
    AONE- American Organization of Nurse Executives
  41. Purpose is to work toward uniform terminology and definitions in nursing diagnosis, and t share these ideas.
    NANDA- North American Nursing Diagnosis Association
  42. Misc Others-
    National Associations of Hispanic, Black Nurses American Assembly for men in nursing NAPNES- for LPN's American Associations of : Critical Care Nurses, Preoperative RN's, Occupational Health Nurses, Religious Oriented Organizations and Educational Ori
  43. Free or low cost screens & health info
    Preventative services
  44. Different financial situations change ins. coverage, ability to get care and what type of care
    Rationing of health care
  45. Health Maintenance Program which are prepaid, group managed care, usually have to stay "in network of md's"
    HMO- Health Maintenance Organizations
  46. Healthcare provided in defined demo area. Is centered to individuals and family
    Community based care
  47. system in which the use of healthcare services are controlled and monitored there are usually protocols for tx and is usually preapproved
    Managed Care
  48. used by HMO's & PPO's to keep costs low - usually seen as a way to deny tx
  49. wearable/ implantable monitors for medical conditions
    physiological monitoring
  50. IVD computer analysis speeds diagnosis ( blood, urine, body tissue samples)
    Diagnostic techniques
  51. wearable/ implantable insulin or glucose pumps, medicated stents
    Drug Admin
  52. 3 types of health organizations
    Primary, Secondary and Tertiary
  53. contact with pt. is minutes to hours
    In and Out Care (ex- ER, office visits)
  54. Provides care to pts where stay is less than 24 hours
    Short- Stay
  55. care is more than 24 hours but less than 30 days
    Acute care
  56. longer than 30 days for chronic illness may be for a lifetime or recovery period
    Long term Care
  57. services owned by state, federal or local gov't may use tax dollars
    Government Owned facilities (ex-VA)
  58. investor owned and operated by corp or stockholders
    Proprietary agencies
  59. Operated by universities, religious organizations, and fraternal groups. All profit above that needed for maint. and operations must go to improvement and growth
    Non-Profit Agencies
  60. Used to describe a client's condition
  61. type of service that is often a special unit in a hospital usually less than 30 days
    Sub Acute Care
  62. service that does observation, assessment, teaching and training, direct skilled nursing such as tube feedings, vents, RN must be in charge of care
    Skilled Nursing Care
  63. refers to care focused on meeting deficits of ADL's
    Custodial Care
  64. provides medical, nursing, social work, spiritual support, for pts and families during a terminal illness
    Hospice Care
  65. designed to restore health and function
    Rehab care
  66. Care is provided and then the patient is discharged soon after
    Ambulatory Care also called outpatient care
  67. care that is provided outside of a health care clinic, hosp. usually provided in the home
    Home Health Care
  68. Med/ Surg, OB, ER and diagnostic center plus lab services
    General or Community Hospital
  69. Level 1 Trauma Center, Burn Center, Oncology, and other levels of care
    Tertiary care hospital
  70. Offers only a particular type of care such as Psych, or Peds
    Specialty Hosp
  71. Places offering healthcare must be approved by the gov't agency, usually the Dept of Health they need this cert
    Governmental Approval
  72. agencies that seek Medicare/ Medicaid funding must meet specific standards and also have many DEEMED STATUS agencies that services need this certification
    Medicare/ Medicaid Certification
  73. Hosp and nursing homes get this accreditation
    JCAHO- Joint Commission on Accreditation of Healthcare Organizations
  74. Organization that provides voluntary accreditation. Has a peer-reviewed process
    CHAP- Community Health Accreditation Program
  75. This reviews and evaluates HMO's it provides HEDIS- Health Plan Employer Data & info Set to compare HMO's
    National Committee for Quality Assurance (NCQA)
  76. She used her contacts with powerful men in govt to obtain supplies and personnel needed to care for the wounded during Crimean War
    Florence Nightingale
  77. Was able to fight incompetence & obtain decent care for the wounded Civil War soldiers by using influential people in Washington
    Hannah Ropes
  78. used the buildup and excitement of the World's Fair to bring together nurses and form the first nursing organization
    Isabel Hampton
  79. This document defines nursing legally, and the scope of nursing practice is outlined.
    Nurse Practice Act
  80. "The act of utilizing the environment of the patient to assist him in his recovery"
    Florence Nightingale
  81. "The unique function of the nurse is to assist the individual, sick or well, in the performance of those activities contributing to the health or its recovery" that would do for themselves if they could
    Virginia Henderson
  82. Defines nursing, describes what nurses do, and provides goals and outcomes of care
    Nursing Theory
  83. Nurses derive knowledge through Carpers patterns of knowing 4
    Empirical (scientific), aesthetic (creative) knowledge, personal knowledge and ethical knowledge.
  84. a particular viewpoint or perspective "a worldview"
  85. the major concepts in a discipline that names the phenomena of concern
  86. Made up of concepts and propositions
  87. these are mental images of a phenomenon
  88. this describes the relationship between concepts
  89. The structure that links concepts together, representing a unified whole.
    Conceptual framework
  90. a symbolic representation of a theory, shown through diagrams, words, or notations,
    Conceptual model
  91. This provides an overall framework for structuring ideas
    Grand theory
  92. This is used to address more narrowly defined phenomena and can be used to suggest an intervention
    Middle-range theory
  93. A meta-paradigm in nursing has 4 areas
    Person, Health, Environment and Nursing
  94. The individual, family or group in a meta-paradigm
  95. The continuum of wellness to terminal illness in the meta-paradigm
  96. The place or community where care is provided in a meta-paradigm
  97. The actions; interactions of the nurse with the person in a meta-paradigm
  98. There are 4 levels of KNOWING:
    empirical, aesthetic, personal, ethical
  99. She is recognized as the first nurse theorist. She describes nursing as both an art and science. She recommended adjusting the environment to improve a person's health.
    Florence Nightingale
  100. She described 4 conservation principles for nursing, specifically the conservation of energy, structural integrity, personal integrity, and social stability. She also stated people need nursing when they are unable to care for themselves.
    Myra Levine
  101. She developed the theory of Human Caring and described 10 carative factors.
    Jean Watson
  102. She developed the theory of the Science of Unitary Human Beings, in which the person is a unified whole, greater than the sum of parts.
    Martha Rogers
  103. She emphasized understanding the person's lived experiences as related to health.
    Rosemary Parse
  104. This is an example of middle-range theory and uses 11 functional health patterns to provide a framework for assessment, nursing dx, and a plan of car.
    Gordon's Functional Health Patterns
  105. Hildegard Peplau- Peplau's interpersonal relations model *environment not defined
    P- Focus on the individual- they live in an unstable equilibrium & strive to reduce anxiety H- Moving toward a direction of being creative, constructive, productive, & personal and community living N- Sick person and nurse therapeutic communication
  106. Virginia Henderson- definition of nursing
    P- complete being who has 14 fundamental needs E- aggregate the external conditions & influences H- Requires independence 7 interdependence Must be able to do the 14 basics unaided N- to assist those who cannot do by themselves
  107. 14 fundamental needs
    breathing, eat, drink, eliminate, move & maintain posture, sleep & rest, dress & undress, maintain body temp, keep clean, avoid danger, communicate, worship, work, play and learn
  108. Madeleine Leininger - cultural care diversity & universality theory
    P- Human beings are caring & capable of feeling concern E- *none* H- a state of well being that is culturally defined, valued & practiced N- uses problem solving approach, 3 models of action- see next card
  109. 3 models of action in Leininger's theory
    culture care preservation, culture care accommodation, and culture care re-patterning
  110. Orem's self care theory- Dorothea E. Orem
    P- a unity who can be viewed as functioning biologically, symbolically & socially, and who initiates & performs on their own to maintain health and well being. H- Well being is used in the sense of the person's perceived condition of existence.
  111. Orem's theory regarding Nursing
    Nursing is a deliberate action, a function of the practical intelligence of nurses & action to bring mundanely desirable conditions.
  112. Roger's science of unitary human beings- Martha E. Rogers
    P- Different from the sum of its parts. Continuous repatterning. E- Each is specific to its given human field. H- + health= wellness.
  113. Roger's theory regarding Nursing
    A humanistic science dedicated to compassionate concern with maintaining & promoting health, preventing illness, & caring for & rehabilitating the sick and disabled.
  114. Roy's adaption model- Sister Callista Roy
    P- a bio-psycho-social being who is constantly interacting with the environment & who has 4 modes of adaption H- a state & process of being & becoming an integrated & whole person. N- care & well being of humans, rooted in beliefs about the human person
  115. Roy's 4 modes of adaption based on
    physiologic needs, self-concept, role function, and interdependence
  116. Watson's human caring theory- Jean Watson
    P- Person is greater than & different from the sum of parts. Individuality is important. H- High level of physical, mental, and social functioning. E- Social, cultural and spiritual influences of society. Sets goals
  117. Watson's theory re: nursing-
    Nursing combines the research process with his problem solving approach & is concerned with promoting and restoring health, preventing illness & caring for the sick.
  118. King's goal attainment theory- Imogene King
    P- 3 interacting systems, the personal systems is unified complex whole self who perceives, thinks, desires, imagines & decides, identifies goals & selects means to achieve it. E- is constantly changing H- continuous adaption to stress to achieve max pote
  119. King's theory re: nursing-
    A helping profession that assists individuals & groups in society to attain, maintain, & restore health or to help individuals die with dignity.
  120. King’s 3 interacting systems
    Individuals (personal), groups (interpersonal), and society (social) systems.
  121. Neuman's systems model- Betty Neuman
    P- The total person is mad of physiologic, socio-cultural & developmental variables. E- people maintain varying degrees of harmony & balance H- Illness = lack of harmony among parts & subparts of the system
  122. Neuman's theory re: nursing
    Unique profession in that it is concerned with all variables affecting an individual's response to stressors, which are intra, inter & extra personal in nature. The nurse helps the pt through primary, secondary & tertiary prevention to maintain stability
  123. Florence Nightingale's Environmental theory
    P- ind. with vital reparative processes to deal with disease & desirous of health but passive in terms of influencing the environment or nurse. E- See alt card H- Health is maintained through preventions of disease from envir. Factors.
  124. Florence Nightingale’s major concepts of health
    • ventilation, warmth, light, diet, cleanliness, and
    • absence of noise
  125. Florence Nightingale's theory re: nursing
    Provision of optimal conditions to enhance the person's reparative process from being interrupted.
  126. a set of guidelines for providing high-quality nursing care & criteria for evaluating care
    Standards of nursing practice
  127. who sets the standards for nursing practice
    The American Nurse Associations Standards of Nursing Practice.
  128. Laws in each state that are instrumental in defining the scope of nursing practice. They protect public health, safety and welfare. State boards of nursing oversee this statutory law
    Nurse Practice Acts
  129. Nursing care plans are based on nursing process
    They outline the nursing care to be provided. It is a set of actions the nurse will implement to resolve nursing problems identified by assessment.
  130. The creation of the nursing care plan is a? stage of the nursing process
    Intermediate- it guides in the ongoing provision of nursing crew & assists in the evaluation of that care.
  131. Characteristics of a quality nursing care plan
    -It focuses on actions which are designed to solve or minimize the existing problem -it is a product of a deliberate systematic process -it relates to the future -it is based upon identifiable health & nursing problems
  132. Elements of the nursing care plan
    NANDA nursing dx with related factors & diagnostic criteria -nursing outcome classifications with specified outcomes to be achieved including deadlines -Nursing intervention classifications with specified interventions
  133. Tools or guidelines that direct are by identifying expected outcomes
    Critical Pathway
  134. a plan of care based on standards that reflect optimal timing of sequential steps provided by all members of the team or managing chronic health problems
    Care Map/ clinical pathways
  135. Basics of a critical pathway
    -represents a sequential, interdisciplinary, minimal practice standard for specific pt population -provides flexibility to alter care to meet ind. pt needs -abbreviated format, broad prospective -phase or episode driven -ability to measure cause & eff
  136. Evidence based practice guidelines
    Integrating individual clinical expertise with the best available external clinical evidence from systematic research.
  137. These may be established for the care of pts with specific illness, treatments, or surgical procedures.
    Evidence based guidelines
  138. components of these guidelines
    -identify a specific area of concern -review the published literature -critically analyze the lit to be certain it is accurate & relevant to area of concern
  139. a process that uses observable & verifiable info, collected in a systematic manner to describe, explain, or predict events
  140. a study in which items can be counted or measured & statistics can be used to analyze the results
    Quantitative research
  141. pure or lab research that is designed to generate & refine theory
    basic research
  142. also called practical research, it is designed to directly influence or improve clinical practice
    applied research
  143. 4 types of quantities research
    Descriptive, correlation, Quasi-experimental, and Experimental
  144. explores and describes events in real life situations, describing concepts
    Descriptive Research
  145. examines the type & degree of relationships between 2 or more variables
    Correlation Research
  146. Examines cause & effect relationships between selected variables. Often conducted in nursing research t examine effects of interventions on pt outcomes
    Quasi- Experimental Research
  147. examines cause & effect relationships between variables under highly controlled conditions
    Experimental Research
  148. something that varies and has different values that can be measured
  149. the variable being studied, determined as a result of a study
    Dependent variable
  150. causes or conditions that are manipulated or identified to determine the effects on the dependent variable
    Independent variable
  151. statement of relationships between the independent & dependent variables that the researcher expects to find
  152. info the researcher collects from subjects in the study- expressed in numbers
  153. devices used to collect & record the data
  154. the systematic collection & analysis of more SUBJECTIVE narrative materials
    • Qualitative Research which is used to gain greater understanding of the experience of the pt & family and may help the nurse t identify areas to explore
    • with pt & family
  155. 4 types of Qualitative Research Methods
    PHENOMENOLOGY- describes exp as they are lived by the subjects being studied GROUDED THEORY- how people describe their own reality & how their beliefs are r/t actions in a social scene other 2 on next card
  156. * other 2 methods
    -ETHNOGRAPHY- examines issues of a culture that are of interest to nursing -HISTORICAL- examines events of the past to generate understanding of nursing profession
  157. QUANTITIVE RESEARCH -objective -deductive * tests theories -General sable -Numbers
    QUALITATIVE RESEARCH -Subjective -inductive * generates theories -NOT general sable -Words
  158. Keys to critiquing research reports
    -Source -author -content -consensus
  159. Informed consent
    The pt's right to consent knowledgeably to participate in a study or tx without coercion or to refuse to participate without jeopardizing the care that he/ she will receive. The right to confidentiality, & to be protected from harm
  160. any eval of services provided & the results achieved are compared with accepted standards
    Quality Management/ Quality Improvement 1st- actual results are compared with standard results then any deficiencies noted or identified serve to prompt recommendations for improvement
  161. a Medicare/ Medicaid review organization that evals preadmission, pre-procedure, concurrent or retrospective review.
    PRO- Peer Review Organization. The purpose is to determine if care given was necessary & appropriate.
  162. Outcome Measures
    Are the actual health results in pts & communities served? Key indicators or QI (quality indicators) show effectiveness of the system as a whole & indicate whether access to services is available.
  163. Include infection rates & morbidity/mortality rates associated with specific hospitals & procedures.
    Hospital Healthcare Outcomes
  164. 3 groups under HCUP- Healthcare Cost & Utilization Project used to determine quality of care & access to care
    prevention, inpatient & pt safety quality indicators
  165. Long term quality indicators
    There are 11 areas of care with 24 quality indicators. They represent common conditions & items that are important to residents & serve as the focus for surveyors.
  166. Purpose of this was to establish national goals to serve as a focus by individuals, organizations, & the government.
    National Health Indicators
  167. National Health Indicators do this
    Process-Identify Need- Assemble Team- Collect data- use nursing audits or peer review- establish outcomes- Evaluate
  168. Risk Management
    An effort to reduce & assess risks to pts, staff, & organizational assets within a health care institution. They identify risks and review & apprise safety protocols
  169. In review & appraisal they do this
    1. STRUCTURE EVAL or audit focuses on environment in which the care is provided. Standards describe physical facilities & equipment; organizational characteristics, policies & procedures, fiscal resources, personnel resources.
  170. They then- PROCESS EVAL which is the nature & sequence of activities carried out by nurse implementing the nursing process. Criteria make explicit acceptable levels of performance for nursing actions r/t pt assessment, dx, planning, implementation, & eval
    OUTCOME EVAL- focuses on measurable changes in the health status of the pt or the end results of nursing care. The proper environment for care & the right nursing actions are important; the critical element is demonstratable changes in pt health status
  171. LEGAL- addresses the general welfare of the public. A violation of this law is a called a crime & is prosecuted by the gov't.
  172. This law regulated conduct between private individuals or businesses & is enforced through the courts as damages or monetary compensation.
  173. a rule or formal regulation established by the gov't legislative authority such as Congress, the state legislature or city council, that appears in writing
  174. This is published in codes. It is broken down into specific rules. it includes constructional laws and enacted laws
    Statutory Laws
  175. Is derived from common usage, custom or judicial law. it is based on occurrences of events, it is less clear & exact that statutory law
    Common law- ( FYI- statutory law & regulatory law carry more weight in court than common law does)
  176. These are civil wrongs committed by 1 person against another person or their property. It can include physical harm, psychological harm, harm to livelihood, or some other less tangible value such as harm to reputation.
    TORT- it can also be a crime- gross negligence that demonstrates that offender is guilty of complete disregard for another's life may be tried as both a civil & a criminal action & is prosecuted under criminal & civil law.
  177. When the outcome is planned, although the person involved may not have believed the outcome would be harmful
    intentional tort
  178. When a wrong is committed against another person or property that was not intended to happen.
    Unintentional tort. Most common cause of an unintentional tort is negligence.
  179. the carelessness or failure to act as a prudent person would normally act under the same circumstance; unintended failure of a person to act or not act as a reasonable person would/would not act in a similar scenario
  180. 4 essential characteristics of negligence
    1. Harm must have occurred. 2. The negligent person must have been in a situation where they held a duty toward the person harmed. 3. Breach of duty 4. The harm must be shown to have been caused by a breach of duty.
  181. Breach of duty
    Includes either doing or not doing what should have been done (commission of an inappropriate action) or not done. Failing to act as a reasonable prudent person. Failure to perform an act required by law or performing in an unlawful way
  182. used to identify a specific type of negligence of a specifically trained or educated person in the performance of his/her job
    Malpractice. To prevent this maintain a high standard of care, excellent communication with pt and family, be aware of policy & procedures. They are an adequate defense against a claim. Avoid short cuts & work around.
  183. Therapeutic communication includes;
    listening, clarifying, & problem solving
  184. Elements of Malpractice
    1. Harm to an individual 2. Breach of duty b the professional 3. Duty of a professional toward an individual 4. breach of duty as the cause of harm
  185. Intentional & unlawful offer to touch a person in an offensive, insulting or physically intimidating manner.
  186. The touching of another person without the person's consent.
  187. invasion of privacy
    All info re: pt's is confidential or private whether it is on paper, computer or spoken. this includes; unnecessary exposure of pt's during care, talking with pt's in rooms that aren't soundproof, sharing pt info, interacting with pt's family re: HIPPA
  188. The willful & purposeful misrepresentation that could cause or has caused loss or harm to a person or property.
    Fraud- Misrepresentation of a product is a common fraudulent act.
  189. an intentional tort in which one party makes derogatory remarks about another that diminish the other party's reputation & is grounds for an award of civil damages
    Defamation of character
  190. written form of defamation
  191. oral form of defamation
  192. making a person stay in a place against their wishes
    False Imprisonment- the law always requires the least restrictive measures in care including with restraints (physical or medical)
  193. abandonment
    - Each state has different definitions. Nurses cannot leave their patients when they are needed.
  194. an agreement between 2 parties or more, especially one that is written & enforceable by law
    Contract- these are often implied with pts. Courts will uphold that an implied contract exists obligating the nurse to be competent & to provide responsible care.
  195. Elements of a valid contract
    PREAMBLE- an explanation or summary of the contract TERMINATION CLAUSE- a portion of a contract that explains the rights of the parties to terminate, or cancel, their contract.