Benner's stages of nursing proficiency
1. Novice-beginning nursing student
2. Advanced Beginner-some level of experience with the situation
3. Competent-in the same clinical position from 2-3 years
4. Proficient-more than 2-3 years of experience in the same clinical position
5. Expert-diverse
QSEN (Quality and Safety Education for Nurses)
Patient-Centered Care
Teamwork and Collaboration
Evidence-Based Practice
Quality Improvement
Safety
Informatics
Scope and standards of nursing practice
(ANA)
Standards of Nursing Practice
assessment, diagnosis, outcome identification, planning, implementation, evaluation
Nursing process
Is the foundation of clinical decision making and includes all significant actions taken by the nurse in providing care
Professional roles of nursing
Autonomy and accountability:the initiation of independent nursing interventions without medical errors/responsible professionally and legally for the type and quality of nursing care provided
Caregiver: you help pt's maintain and regain health, manage dis
Code of Ethics (ANA)
the statement of philosophical ideals of right and wrong that define the principles you will use to provide care to your pt's. Guide for carrying out nursing responsibilities and providing quality nursing care.
NCLEX examination
is the same in every state; it provides a minimal stands of knowledge for an RN in practice.
Advanced practice nurses
MSN
Clinical nurse specialist: provide diagnosis, treatment, and ongoing management of pt's in all health care settings.
nurse practitioner:
certified nurse-midwife
certified nurse anesthetist
nurse researcher
conducts evidence-based practice and research to improve nursing care and further define and expand the scope of nursing practice
ANA Standards of Professional Performance
ethics
culturally congruent care
communication
collaboration
leadership
education
evidence-based practice
quality of practice
professional practice evaluation
resources utilization
environmental health
Florence Nightingale
first epidemiologist
organized first school of nursing
improved sanitation in the battlefield
"let us never consider ourselves finished nurses... we must be learning all of our lives.
Nurse Practice Act
Stablished by ANA; representative of the scope of nursing practice as defined in most states. it protects public heath, safety and welfare.
also, protects the public from unqualified and unsafe nurses.
Orem's Self-Care Deficit Theory
pt's ability to perform SELF CARE. people who participate in self care activities are more likely to improve their health outcomes.
Components of health care system
licensed providers:
registered nurses
licensed practical nurses
advanced practice nurses
physicians
dentists
dieticians
physical, respiratory and occupational therapists
Unlicensed providers: assistive personnel
Levels of health care
Preventive, primary, secondary, tertiary, restorative, and continuing.
Preventive Health care
focuses on educating and equipping clients to reduce and control risk factors of disease. Examples include immunizations, stress management programs, and seat belt use
Primary Health care (Health Promotion)
emphasizes health promotion, and includes prenatal and well-baby care, nutrition counseling, and disease control. Examples: schools, nursing homes, physician office, & community health centers
Secondary health care (Acute Care)
provided by a specialist or agency upon referral by primary health care provider Examples: urgent care, hospital emergency care, radiological procedures, ambulatory care.
Tertiary health care
specialized consultive care. Example: Burn Unit, ICU, & oncology centers.
Restorative care
help individuals regain maximal functional status. Examples: Home Care, Rehabilitation, and nursing home
Continuing health care
hospice
Healthy People 2020
increase life expectancy and quality of life and eliminate health disparities.
what is the shifting role of a community based nurse?
tend to provide illness care within the community setting. it requires critical thinking and decision making for the individual pt and family. (community is the client)
Focus of community based nursing
-Health promotion (vaccines)
-disease prevention (eating habits, bp checks)
-restorative care (improving quality of life)
Structure, people, social system
Health disparities
a particular type of health difference that is closely linked with social, economic, and environmental disadvantage.-> poor health status, disease risk factors. poor health outcomes and limited access to health care; often influenced by the conditions and
social determinants of health
The conditions in which people are born, grow, live, work, and age, shaped by the distribution of money, and power. Age, race, ethnicity, socioeconomic status, access to nutritious food, transportation resources, religion, sexual orientation, age, level o
social determinants of health
are of mostly responsible for health disparities seen with and between countries.
Vulnerable populations
groups of patients who are more likely to develop health problems as a result of excess health risks, who are limited in access to health care services, or who depend on others for care
vulnerable populations include
those living in poverty, older adults, the disabled, people who are homeless, immigrants, individuals in abusive relationships, people living with substance abuse, and people with mental illness.
community assessment STRUCTURE
-name of community or neighborhood
-geographical boundaries
-emergency services
-water and sanitation
-housing
-economic status
-transportation
-safety
community assessment POPULATION
-age distribution
-sex distribution
-growth trends
-density
-educational level
-predominant ethnic groups
-predominant religious groups
community assessment SOCIAL SYSTEM
-educational system
-government
-communication system
-welfare system
-volunteer programs
-health system
community assessment
is the systematic data collection on the population, monitoring the health status of the population, and making information available about the health of the community. this is the environment in which pt's live, work, play, and learn.
Nursing Metaparadigm
allows nurses to understand and explain what nursing is, what nursing does, and why nurses do what they do.
-person
-health
-environment/situation
-nursing
Nursing process is central to nursing practice. Nursing practice:
is derived from a theory
nursing theories provide nurses with perspectives from which to:
analyze patient data
nursing theory
Describes, explains, predicts, and/or prescribes nursing care
vulnerable populations of its are those who are more likely to develop health problems as a result of:
abusive habits.
in identifying needs for health policy and health program development and services , a community assessment focuses on which of the following elements:
Structure, people, social systems, & environments.
Nursing is defined as a profession because:
practice autonomy
professional nursing speciality organizations seek to:
-improve standards
-expand nursing roles
-improve welfare of nurses in speciality areas
health disparities are unequal burdens of disease morbidity and mortality rates experienced by racial and ethnic groups. these disparities are often exacerbated by:
-bias
-stereotyping
-prejudice
you are in the process of admitting an ethnically diverse pt. to plan cultural care, you will conduct a cultural assessment that includes:
Ethnohistory
For a student to avoid a data collection error, the student should:
assess the pt and if unsure of the findings as a faculty member to assess the pt
a pt is admitted to the hospital with shortness of breath. as the nurse assesses this pt the nurse is using the process of:
Data Collection
the nursing process organizes your approach to delivering nursing care. to provide care to your pts, you willed to incorporate nursing process and
Critical thinking.
Leininger culture care theoty
transcultural nursing
Maslow's Hierarchy of Needs
basic human needs necessary for survival and health:
1. self actualization
2. self-esteem
3. love and belonging needs
4. safety and security (physical safety, psychological safety)
5. physiological (oxygen, fluids, nutrition, body temp, elimination, shelt
R A C E
rescue, alarm, confine, extinguish/evacuate
Peplau's Theory
nurse-patient relationship
also known as the mother of psychiatric nursing.
Primary source of data collection
PATIENT
secondary source: family, friends, medical records.
Back channeling
includes active listening prompts such as "all right", "go on", or ""uh-huh".
What is a cue?
symptoms/problems
subjective data
pt's verbal description of their health problems. examples: pt feeling, perceptions, and self reported problems.
objective data
direct observation; what you hear, see, touch. HEAD TO TOE ASSESSMENT
How to write a nursing diagnosis
-patient problem related to etiology as evidenced by defining characteristics
P -problem
E -etiology (cause)
S -symptoms
AMERICAN NURSES ASSOCIATION
defines scope and standards of nursing of our practice
secondary and tertiary care is provided;
in ED, urgent care, critical care, inpatient medical surgical units.
critical thinking
Attitude, knowledge, experience, standards
opened ended questions
BEST TECHNIQUE for pt interviews. allows pt to actively describe their health status.
components of patient centered interview
observation and setting an agenda
working phase-collecting data
interview techniques
observation
opened-ended questions
direct close-ended questions
leading questions
Bach channeling
probing
interpret termination phase
culturally congruent care
or transcultural care; emphasizes the need to provide care based on an individual's cultural beliefs, practices, and values.
Ethnohistory
history of the pt's culture. Include in cultural assessment to plan culturally competent care when admitting a new pt that's ethically diverse.
Intersectionality
policy model used to study the complexity of people's lives and experiences
social groups: mom, daughter, employer, student
Risk Diagnosis
Vulnerability
has not happened yet!
Focus of Primary Health Care
promotion
prenatal and well baby care, family planning, nutrition counseling and disease control.