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What 5 steps are in the Knowledge portion of the nursing competency wheel?
What 6 qualities are needed for the nursing process?
1. Intellectual skills
2. Interpersonal skills
3. Psychomotor skills
4. Creativity & curiosity
6. Critical thinking
Patient centered care helps?
Make the patient the focus of care and takes the patient needs and wants into consideration when planning nursing interventions.
Patient care focuses on what 3 aspects?
1. Considering what the patient has to say about their care plan.
2. Addressing their pain.
3. Acknowledging what impact their culture & ethnicity have on their care.
The Patient Care Partnership focus on what 6 things?
1. High quality hospital care.
2. A clean and safe environment.
3. Protection of your privacy.
4. Involvement in your care.
5. Preparing you and your family for when you leave the hospital.
6. Help with your bill and filing insurance claims.
Advance Directives deal with which 2 laws?
1. Advanced Care Medical Directives.
2. Durable Power of Attorney for Health Care.
Advanced Care Medical Directives are?
Specifications for what interventions patients would or wouldn't want if they were unable to communicate. Such as DNR, DNI, CMO, etc.
What is Durable Power of Attorney for Health Care?
A legal document appointing a person or persons to carry out the patient's wishes about health care on their behalf if they couldn't communicate. Such as a health care proxy.
Informed Consent include what 4 things?
- 1. Disclosure.
- 2. Comprehension.
- 3. Competence.
- 4. Voluntariness.
Disclosure of Informed Consent means?
Making sure they understand all the informations and risks. All the "what if's".
Comprehension of Informed Consent means?
Do they understand and if not, breaking it down to simple terms.
Competence of Informed Consent means?
How oriented and alert they are to make their own decisions.
Voluntariness of Informed Consent means?
Are they doing it by their own will or being influenced by someone else?
Demonstrating accountability for the delivery of standard based nursing care that is consistent with moral, altruistic, legal, ethical, regulatory, and humanistic principles.
Role of the professional nurse, 4 things?
- 1. Provider of direct care.
- 2. Manager of health care services.
- 3. Client teacher- teaching the patient skills.
- 4. Client Advocate- standing up for Patient's rights.
What defines Nursing in MA?
Massachusetts State Law
The Board of Registration identifies?
Requirements for licensure.
Who renews licenses and requires continuing education?
The Board of Registration.
The Board of Registration is governed by?
The Board of Registration in Nursing.
An individual is licensed by __ to practice professional Nursing?
The Board of Registration.
Who sets standards for approves schools?
The Board of Registration
Who requires fees every 2 years?
The Board of Registration
Who revokes and sets penalties for practice without a license?
The Board of Registration.
Massachusetts Nurse Practice Act is pursuant to?
Massachusetts General Laws
Massachusetts Nurse Practice Act is responsible for?
Care provided to individuals and groups.
Massachusetts Nurse Practice Act systematically assess?
Massachusetts Nurse Practice Act analyze and interpret?
Massachusetts Nurse Practice Act plan and implement?
Nursing interventions & prescribed medical regimens.
Massachusetts Nurse Practice Act provide and coordinate?
Massachusetts Nurse Practice Act evaluates?
outcomes and initiate change.
Massachusetts Nurse Practice Act collaborate?
with other health care providers for quality and continuity of care.
Massachusetts Nurse Practice Act serves?
as a patient advocate
America's Nurse's Association (ANA) is for?
Nurses and their safety.
The ANA sets?
Standards and salary along with the MNA
The ANA allows in?
The ANA promotes?
Economic and general welfare.
The ANA promote professional?
Development/standards of practice.
The ANA lobby?
for health and nursing issues.
What are the 2 kinds of Torts?
- 1. Intentional.
- 2. Unintentional.
What is a Tort?
A civil wrong that causes someone else to suffer loss or harm.
What are 6 Intentional Torts?
- 1. Assault & Battery.
- 2. Defamation of Character.
- 3. Fraud.
- 4. Invasion of Privacy.
- 5. False Imprisonment.
- 6. Negligence.
What is Assault?
Threat of touching without consent.
What is Battery?
To touch, actual carrying out of the threat.
What is Defamation of Character?
False communication resulting in damage or injury to reputation.
What are two things in Defamation of Character?
What is Libel?
Written/print or pictures
What is Slander?
What is Fraud?
Willful misrepresentation. To say certified in an area are are actually not.
What is Invasion of Privacy?
Inappropriate exposure and discussion with inappropriate parties- even if the information is true. HIPPAA violation.
What could prevention of movement or unjustified retention without consent be justified as?
What is needed for restraints?
A written MD order and correct agency policies. Cannot restrain anyone who is alert, oriented, and capable of decision making.
What is a Section 12 & Section 35?
Mental impairment- committed involuntarily in accordance with court proceedings if dangerous to self or others.
What is Negligence?
Responsible person refusing to do something a normal person would do in normal circumstances.
To prove Malpractice what 4 things are needed?
- 1. Duty
- 2. Breach of Duty
- 3. Proximate Cause
- 4. Damages
What is Duty in Malpractice?
duty owed to the client/plaintiff
What is Breach of Duty in Malpractice?
Failure to meet the standard of practice/care.
What 3 things are included in Ethics?
- 1. Standards of Conduct
- 2. Moral Judgment
- 3. Values
What is Values?
Based on your own beliefs & morals. What you personally believe to be right and wrong.
Ethical Dilemmas in Healthcare?
- 1. Client Research
- 2. Research
- 3. Public Policy
- 4. Delivery of services
4 Ethical Rules of Professional Client relationship?
- 1. Privacy
- 2. Confidentiality
- 3. Veracity
- 4. Fidelity
What are 3 Ethical Principles?
- 1. Beneficence
- 2. Nonmaleficence
- 3. Autonomy
What is Beneficence?
To do or promote good. The client's best interest as defined by the client themselves.
What is Nonmaleficence?
To do no harm, to remove from harm or to prevent harm.
What is Autonomy?
Self determination, independent choice. The basis for the clients right to self decisions. Ability to give consent, receive treatment or refuse care, dictate advance directives, ect.
What is Justice?
- 1. Principles of fairness- treat all clients equally.
- 2. Equal share of available resources.
What is Veracity?
What is Fidelity?
Fulfillment of one's duties and obligations to vows or promises. Following through on promises or your word.
5 Rights of delegation and supervision of an RN?
- 1. Task
- 2. Person
- 3. Situation
- 4. Communication
- 5. Evaluation
RN's can delegate what activities to a UAP?
Activities what do NOT require nursing assessment and judgment during implementation.
RN's can delegate what activities to LPNs?
Activities that require technical skills with predictable outcomes.
The Nurse of the Future will demonstrate?
an awareness of and responsiveness to the larger context of the health care system and the ability to call on microsystem resources to provide care that is of quality and value.
The Nurse of the Future looks at the?
The whole health care structure. How an individual floor is effected by national or state. Or internal such as dietary bringing food to a patient.
What 3 Organizations have a Microsystems impact?
What is the CDC?
Centers for Disease Control and Prevention. A federal agency for protecting the health and safety of people at home or abroad.
What is JCAHO?
The Joint Commission on Accreditation of Healthcare Organization. An arm of 5 professional groups what represent the interests of doctors, dentists and hospitals. Nongovermental and voluntary to establish standards for operation of facilities.
What is OSHA?
Occupational Safety and Health Administration. Focused only on employee safety. Sets standards what facilities are expected to follow. Provides training, outreach and education.
What is HIPAA?
Health Insurance and Portability and Accountability Act. Governs privacy and security of health information. Sets national standards to protect people's medical records from unauthorized people.
What is Therapeutic Communication?
- 1. Active listening
- 2. Reflective questions
- 3. How you interact with the patient by your presentation or body language.
What is Physical Attending?
Being present with the patient and not feeling rushed.
What is open ended questions?
Asking questions in a way to draw out more information besides a yes or no.
What is Restatement?
Restating what patients say to validate it.
What is Reflection?
Rephrasing what they say to get the emotion across.
What is Collegial Communication and Conflict Resolution?
Understanding that nursing is based on collaborative relationships with many people from other cultures, values, and opinions which could result in conflict. Understanding good communication or resolution can decrease the risk of conflict.
What is Teaching and Learning?
Knowing the level of your patient has to understand the education you are trying to teach them. Knowing how to break it down to simple terms to help understanding and involving the client in decisions. Role of RN only.
Role of Professional Relationship?
- 1. Client focus
- 2. Goal oriented- client needs/concerns
- 3. Parameters- has a beginning and end.
- 4. Self information given as needed.
Role of Social Relationship?
- 1. Involved both parties.
- 2. Goals- personal, companionship
- 3. Parameters- social situation relationship ongoing.
- 4. Sharing life events.
4 Phases of the Professional Client-Nurse Relationship?
- 1. Pre-interactional
- 2. Orientatin
- 3. Working
- 4. Termination
Pre-Interactional Phase of the Nurse-Client Relationship?
Examine your feelings, age, diagnosis, cultural considerations, & previous interactions with the client.
Orientation Phase of the Nurse-Client Relationship?
Introduce yourself and role, identify/clarify the client's problem, collect information on health, orient to facility/room/bed/ect, formulate goals to be accomplished, and build trust through privacy and confidentiality.
Working Phase of the Nurse-Client Relationship?
Explore and determine solutions through the Nursing Process (ADPIE)
Termination/Discharge Phase of the Nurse-Client Relationship?
Identify goals met, future needs, closure, and discharge planning with client.
Verbal, Nonverbal, and social factors.
4 Space and Territory levels?
- 1. Intimate- 0-18in
- 2. Personal- 1.5-4ft
- 3. Social- 4-12ft
- 4. Public- 12+ft
Evidence Based Practice is?
Nursing care based on evidence that helps to ensure the patients receive quality care.
Definition of the Nursing Process?
A systematic, problem solving approach used to identify, prevent, and treat actual or potential health problems and promote wellness. Provides a framework and validates nursing.
5 Steps to the Nursing Process (ADPIE)?
- 1. Assessment
- 2. Diagnosis
- 3. Plan
- 4. Implementation
- 5. Evaluation
Gathering relevant data to identify health problems and to establish a base about the clients response to health concerns or ability to manage care.
Assessment uses what 2 things?
Subjective & Objective Data
What is Subjective Data?
Things the patient themselves say. No one can validate it. Ex: "I feel nauseas".
What is Objective Data?
Observable Data. We can validate with someone. Ex: Lab values, vital signs, ect.