Foundations of Nursing Practice

Theory of animism 16th century

everything in nature is alive- good spirits = good health-evil spirits brought death and illness

Florence Nightingale

founder of modern nursing, changed the way nursing was viewed , challenged prejudices against women, elevated the status of nursing, established the first training school for nurses.

Contributions of Florence Nightingale

- identified personal needs of pt and nurses role in meeting them.- established standards for hospital management- established nursing education -recognized the two components of nursing: health and illness. -she believed that nursing is separate and distinct from medicine

19th to 21st century nursing: world war ||

- female nurses were under the control of male hospital admins and physicians. - Large numbers of women worked outside the home and became more independent and assertive-explosion of medicine and technology broadened the role of nurses -growth of nursing as a professional discipline occurred.

ICN (International Council of Nurses)

promote health, prevention of illness, and collaborative care

ANA (American Nurses Association)

social policy statement

Patient is the ___________?

central focus- includes physical, emotional, social, and spiritual dimensions of the patient

Nursing is both a _________ and __________.

a science and art

The 4 Broad Aims of Nursing

- to promote health: (ex: promote sleep)- to prevent illness: ( ex: hand washing)- to restore health: (ex: perform ADL's, ROM)- to facilitate coping with a disability/ death: (ex: support services)

Health defined by WHO

- state of optimal functioning or well being-includes physical social and mental components- not merely absence of disease

Patient centered Health Promotion: Nurses

- Discuss lifestyle choices that enhance quality of life-serve as a role model- encourages health promotion by providing info/referrals- teaches that certain behaviors and factors can contribute to or dimmish health encourage acceptance of responsibility for ones own health -increases health awareness- assists pts in understanding health*** health is more than just being ill.

Nurses Prevent illness by

- Educational programs: ex: prenatal care- community programs: podcasts, youtube, fairs- performing health assessments: objective- encourage healthy lifestyles: diet, exercise

Activities to Restore Health

- performing assessments that detect illness, BP, and measuring blood sugars- referring questions/ reporting abnormal findings to health provider- providing direct care ( physical care like admin. meds, procedures, TX, ROM...)- collabing with health care providers - planning, teaching, and carrying out rehab (like w/ strokes, heart attacks, arthritis.)- working in mental health/chemical dependency programs.

Facilitating coping with disability and death

- Maximizing a persons strengths and potentials (patient teaching, referral to community support systems.)- providing end of life care (hospice)

Disease

pathological changes in the structure or function of the body or mind

Remission

the disease is present but the person does not experience symptoms

Exacerabation

symptoms of the disease reappear (think : cancer, COPD)

Educational Prep for nursing

- practical/vocational- RN education: diploma, associate, then BSN- Graduate..

In many states continuing Education is required for an RN to maintain licensure. MA 15 CEU's is every_________?

2 years

Guidelines for Nursing Practice

- Nursing organizations- Standards of Nursing Practice- Nurse Practice acts and licensure - nursing process

Standards of Nursing Practice allow nurses to...

carry out professional roles- service as protection for the nurse, patient, and institution.- the nurse is accountable quality of practice, responsible use of these standards.

The 3 Levels of Health Promotion: Primary

prevent disease and promote healthex: immunization, education, health diet and exercise

The 3 Levels of Health Promotion: Secondary

screening for early detection and management of disease ex: BP, cholesterol check

The 3 Levels of Health Promotion: Tertiary

management of clinical disease to prevent progression or to avoid complication. ex: teach patient with diabetes how to prevent complications

National Patient Safety Goals Facts

- 2002 The Joint Commission established its National Patient Safety Goals (NPSGs) program- first implemented 2003 to protect patients from harm- goal to improve quality of care and decrease medical errorsestablished to help accredited organizations address specific areas of concern in regard to patient safety

NPSG: Long term Care

- Identify resident correctly- use medication safely- prevent infection- prevent resident from falling- prevent bed sores

NPSG: Acute care

- identify pt correctly- improve staff communication- use meds safely- use alarms safely- prevent infection- identify pt safety risk- prevent mistakes in surgery

How do you identify patients correctly?

- use at LEAST two ways to identify them..pts name + DOB or name on hospital bracelet, and compare medical record number with hospital number.

What is a form of handoff communication?

SBAR report

You should report critical results of tests....

on a timely basis , right staff person on time

When using medicines safely....

- label the ones that are not labeled- take extra care with patients who take medicines to thin their blood- record + pass along correct info about pts meds. (this is called MEDICATION RECONCILIATION.)

When using alarms...

- make improvements to ensure that alarms on medical equipment are heard and responded to on time.

Prevent infection by...

wash your hands, use the proven guidelines to prevent infections

identify patient safety risk by...

find out if and which patients are at risk for trying to commit suicide

how can you prevent mistakes in surgery?

- make sure that the correct surgery is done on the correct patient and at the correct place on their body- mark the correct spot on their body- pause before the surgery to make sure a mistake isnt being made

who reps more than 54.1 million US citizens or about 16% of the population?

person's 65 +

Life expectancy in 1930

59.7

life expectancy in 1965

70.21

life expectancy now

79.05

Authorative knowledge

comes from an expert and is accepted as truth based on the person's perceived expertise-like a senior staff nurse instructs a new grad

scientific knowledge

obtained through the scientific method (research)

traditional knowledge

passed from gen to gen

EBP (evidence based practice)

- a problem solving approach to making clinical decisions, using best evidence possible. - best evidence would be published research, national standards and guidelines, and reviews of targeted literature- blends both science and art of nursing- challenges healthcare professionals to provide care based of scientific evidence.

Part A Medicare:

hospital/home care

Part B Medicare:

medical visits, xray

Part C Medicare:

Medicare Advantage (its optional)

Part D Medicare:

Prescription drug coverage

Gerontological nursing roles healer

practice holistic nursing-mind,body,spirit

Geri Nursing roles caregiver

meet unique needs

Geri Nursing roles Educator

share knowledge and skills

Geri nursing roles Advocate

speak up for older adults

Geri Nursing roles Innovator

think outside the box