NUR1010 Test 3

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NUR1010 Test 3
2014-08-12 20:27:16
NUR1010 Test

NUR1010,Test 3
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  1. Beneficence
  2. Nonmaleficence
    twofold duty:

    • 1. do no harm
    • 2. prevent harm

    • = actual harm and risk of harm
    • = intentional (rare)¬†and unintentional (lack of careful planning, knowledge, skill, ability

    =Nightingale Pledge-> no harm

    e.g. prevent medication error, provide walker, use ambulation belt, ...

    • think critically
    • does this treatment cause more harm or more good for the patient
    • weighing risks and benefits
    • evtl. premedicate (e.g. pain) and carefully assess his status before procedure
  3. Beneficence
    duty to do or promote good

    • depends on the context
    • differnet people might not see the good in an action (e.g. blood transfusion)
    • depends on the rights of the person for whom the action is being taken
  4. justice
    • the obligation to be fair
    • equal treatment to all patients
    • e.g. how to allocate nurse's time , or allocate limited health care resources

    distributive justice-> fair distribution of benefits and burdens

    allocating resources-> competition for same resources (e.g. organ transplantation)

    fair access to care -> equal access to healthcare for all

    compensatory justice -> making amens for wrongs that have been done (e.g. malpractice)

    • procedural justice -> process of ranking and ordering
    • -often "first come first served"
    • -procedures to apply to all clients the same way
  5. Fidelity
    • = faithfulness
    • duty to keep promises
    • basic part of every patients care situation
    • (e.g. promise to keep information confidential, promise to be back to check effectiveness of medication ...)
    • promise is the same, regardless of importance

    make promises in a thoughtful, careful manner to maximize likelihood that you can keep them
  6. veracity
    Duty to tell the truth

    • at times it is hard to determine how much of the truth to tell
    • -> in this, as in most situations,the risk of losing the patient's trust outweighs any benefit of withholding the truth

    BUT act on the familie's/ cultural values

    always consider the context
  7. assault
    occurs when a nurse intentionally places a patient in immediate fear of personal violence or offensive contact

    must include words expressing an intention to cause harm and some type of action

    e.g. "I will slap you" and raising of a hand
  8. battery
    is commited when

    an offensive or harnful contact is made with the patient without his consent

    there is unauthorized touching a person's body by another person

    to avoid charges always get

    informed consent before procedure

    usually general consent signed at admission regarding general procedures (vitalsigns, physical assessment)

    any invasive procedure (e.g. catheter, intrvenous lines) always explain procedure and obtain consent
  9. assault and battery
    occurs when there is the intent to cause a person fear combined with an offensive or harmful contact.
  10. slander
    spoken or verbal form of defamation of character

    not guilty if statement made about person is true or the person has the protection of the "privilege" such as reporting possible child abuse
  11. libel
    written or published form of defamation of character
  12. intentional torts
    action with the intention to harm another person

    harm does not have to be violent, hostile, cause serious amount of pain or distress

    person must merely intend to cause harm

    most commonly encountered in nursing: assault, battery, false imprisonment, invasion of privacy,

    homicide if patient dies bc or nurse's action
  13. quasi intentional torts
    actions that injure someone's reputation

    • -was false
    • -was made to another person
    • -caused shame, ridicule, negative impact
    • -was made as a statement/fact rather than as a opinion
  14. false imprisonment
    restraining people without proper legal authorization

    any type of unjustified restriction

    involuntarily committed to mental health units

    physical restraints or chemical restraints

    restrain if harm for others or patient-> but get immediate proper authorization to continue
  15. malpractice/ negligence liability
    to win recover damages... must prove 4 elements

    • duty
    • breach of duty
    • causation
    • damages

    with enough evidence to tip the scale in his or her favor

    duty: duty forms when a nurse is assigned to a patient, or when nurse observes a patient doing something that could harm the patient

    • breach of duty:
    • -when nurse fails to meet standards of care

    • causation:
    • breach of duty must be direct and proximate cause of the injury suffered by the patient (most difficult element to prove)
  16. whistleblowing
    • identifying a
    • incompetent
    • unethical
    • illegal

    situation or action of others

    -> report it to someone with the power to stop it

    -> be sure that information has been cofirmed through another source

    • that reporting will correct the wrongdoing
    • or prevent future problems

    weigh the risks against the benefits

    e.g. impaired nurse-> should receive assisstance, appropriate entity within memployment setting
  17. advance directive
    group of instructions (oral or written) stating person's wishes regarding health care treatment ( in case patient cannot make decision)

    ordinary power of attorney is not enough for health care decision
  18. occurence or incident report
    formal record of an unusual occurance or accident

    organizationa report and not part of the client's health record

    track problems, quality improvement, -> create safer processes and procedures

    report all errors,

    client, date, time, objective data about incident, identify witnesses, do not blame, quotes of persons involved
  19. student responsibilities
    • same standards of care as are licensed nurses
    • must be familiar with state's standards of practice
    • with policies and procedures in the agency for clinicals
    • assignments within competence
    • own legal responsibilities

    • to help protect yourself:
    • prepare before clinicals
    • never attempt a procedure/ judgement where you feel unsure
    • lack of knowledge-> notify instructor immediatly
    • notify instructor/ nurse if patients health status changes significantly
    • take instructions only from clinical instructor
  20. PICO Question
    • P= People , Population, or Problem
    • What is the Problem, medical diagnosis, situation, ... that needs intervention
    • e.g. patient with impaired skin integrity

    • I= Intervention, treatment, cause, contributing factor
    • Which intervention to consider? What might help/ improve
    • e.g. applying a barrier cream

    • C= Comparison Intervention
    • What other intervention are being considered or used
    • e.g. rinsing well, air drying after incontinence...

    • O= Outcome
    • What effect could intervention realistically have? What do we hope to achieve?
    • e.g. prevent/ achieve less perineal excoriation. any expected undesired sideeffects?
  21. evidence based practice
    • research provides data for evidence-based practice.
    • use research reports and practice guidelines whenever available
    • if no guidelines avail. then just use research findings
    • (similar to research) identify clinical problem, formulate searchable question, search the literature, evaluate the quality of the research, integrate findings into practice
  22. evidence based research- steps of the research process
    Novice level: practice but not perform research

    5 phases:

    • 1. select and define the problem
    • 2. select a research design
    • 3. collect data
    • 4. analyze data
    • 5. use the research findings
  23. Important nurse theorists
    • Florence Nightingale
    • clean and healthy environment and nutritious food
    • research (outcome before and after intervention)
    • changed way the British rmy Hospital system was managed

    • Virginia Henderson
    • army nurse, teacher of nursing "Basic Principles of Nursing Care"
    • "Nurses deserve to know what it means to be a nurse" (handmaiden, ...)
    • 14 basic needs that are addressed by nursing care
    • defined what nursing is in the 20th century
    • " assist ... contributing to health,...gain independence ..."

    • Hildegard Peplau
    • psychiatric nurse
    • advancement of standards in nursing education
    • self-regulation in nursing through credentialing
    • advanced nursing practice
    • developing relationship with (psychiatric)patients

    • Patricia Benner
    • Caring as the central idea "Primacy of caring model"
    • helps client cope
    • helps to give and get help
    • personal concerns for people, events,...
    • which intervention is effective

    • 5 stages of knowledge: novice, advanced beginner, competent, proficient, expert nurse
    • nurse contributes to health according to her skill level

    • Madeleine Leininger
    • caring as cultural competence
    • cultural accommodations for the health benefit of the patient