Transition to RN Exc Excelsior College Transition Course

Transition to RN Exc Excelsior College Transition Course Question Answer Who focused on hygiene and sanitation and believed strongly in continuing education? Florence Nightingale Who organized the American Red c ...

Transition to RN Exc Excelsior College Transition Course Question Answer Who focused on hygiene and sanitation and believed strongly in continuing education? Florence Nightingale Who organized the American Red cross and was responsible for relief operations during the Civil War? Clara Barton Who was the nurse who became responsible for construction of state psychiatric hospitals? Dorothea Dix Conductor of undergrown railraod who assisted Clara Barton to tend to wounded soldiers during the Civil War. Harriet Ross Tubman Born into slavery, nursed Union soldiers, worked to Sojourner Truth improve sanitary conditions, got food and clothing for black soldiers Radical changes in nursing education, reduced student work day from 10 to 8 and eliminated FREE private duty services Isabel Hampton Robb Created FNS Frontier Nursing Service- 1st midwifery training school Mary Breckinridge did a study which resulted in establishment of associate degree nursing education Mildred Montag Nursing leader and women's right activist giving women the right to vote- also a key figure in community nursing and introduced nuring in schools Lavinia Dock Early theorist who taught "a patient is a person who requires help toward independence" Virginia Henderson America's first African American Nurse Mary Mahoney a psychiatric nursedescribed Nurse- Client relationships Hildegard Peplau 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 opened FIRST birth control clinic with her sister in Brooklyn Margaret Sanger Founder of public health nursing - established a neighborhood nursing service in NYC Lillian Wald Religion- *R* Protestant Churches- women subordinate to men- nurse most menial of servants The Reformation Earliest counterpart to community health nursesworldly items were of no concern to nurses, nurses required strict obedience, Order of the Deaconesses devotion, and setting aside themselves Roman Catholic society - sister nurses nursed cholera pt's Mercy Hospitals Sisters of Mercy sisters that visited pt's in homes, hosp, and poorhouses and asylums. Deveoped educational programs for Nurses Sisters of Charity 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 Founded during Crusadesstaffed 2 hospitals in Jerusalem Military Nursing Orders *Military* *M* MilitaryNursing Service formed, Florenece Nightingale cleaned up the hosp, orderlies scrubbed often, camp followers Crimean War scrubbed clothes, and vermin were under control Phiadelphia Dispensary was fomed 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 Amercan Revolution Public saw the need for trained nurses, Clara Barton, Harriet Tubman, Sojourner Truth tended to the soldiers American Civil War Nursing schools were already established and Isabel Robb developed a plan for managing nurses Spanish-American War and the Boer War Increased demand for nurses, Army School of Nursing - nurses needed to be unmarried and of good moral character World War 1 Bolton Act created the US Caet Nurse Corps. Nurses World War 2 got full military commission, post warHill Burton Act MASH units Korean War and Vietnam conflicts Care focused on soldiers and victims of war Gulf War- Afganistan- Iraq *Nursing Organizations Concerns itself with social and economic welfare of nurses, the role of the nurse, the nursing organizations and their their gverning bodies ICN- International Council of Nurses For RN'S- Is involved in all issues that nursing has confronted with Legislation, Collective bargaining, advancement of profession ANA- American Nurse's Association Was formed to assist collegiate schoold of nursing to improve higher education for nursing. AACN- American Association of Colleges of Nursing Was formed to provide accrediation CCNE- Commission on Collegiate Nursing Education Provides a legal regulatory bodies of all states to act together re: boards, exams, licensing NCSBN- National Council of State Boards of Nursing First Nursing Organization in the US. 5 Goalsnursing education development and improvement, faculty development, nursing ed research, data collection, assessment & evaluation NLN- National League for Nursing Baccalaureate program honorary organization for exceptional standards Sigma Theta Tau (STTI) For those who have made significant contributions to nursing- honorary part of ANA AAN- American Academy of Nursing Student nursing organization NSNA- National Student Nurses' Association 4 Purposes to 1. speak for associate degree nursing education and practice 2. Reinforce the value of that degree 3. maintain endorsement for grads NOADN- National Organization For The Associate Degree Nursing with associte degree, 4. retain the RN exam for assocaite degree grads Organization for nurses who design, facilitate, and manage care AONE- American Organization of Nurse Executives Purpose is to work toward uiform terminology and definitions in nursing diagnosis, and t share these ideas. NANDA- North American Nursing Diagnosis Association Misc OthersNational Associations of Hispanic, Black Nurses American Assembly for men in nursing NAPNES- for LPN's American Associations of : Critical Care Nurses, PeriOperative RN's, Occupational Health Nurses, Religious Oriented Organzations and Educational Ori Free or low cost screens & health info Preventative services Different financial situations change ins. Rationing of health care coverage, ability to get care and what type of care Healtth Maintainance Program which are prepaid, group managed care, usually have to stay "in network of md's" HMO- Health Maintenance Organizations Healthcare provided in defined demo area. Is centered to individuals and family Community based care system in which the use of healthcare services are controlled and monitored there are usually protocols for tx and is usually preapproved Managed Care used by HMO's & PPO's to keep costs low - usually seen as a way to deny tx Capitation wearable/ implantable monitors for medical conditions physiological monitoring IVD computer analysis speeds diagnosis ( blood, urine, body tissue samples) Diagnostic techniques wearable/ implantable insulin or glucose pumps, medicated stents Drug Admin 3 types of health organizations Primary, Secondary and Tertiary contact with pt. is minutes to hours In and Out Care (ex- ER, office visits) Provides care to pts where stay is less than 24 hours Short- Stay care is more than 24 hours but less than 30 days Acute care longer than 30 days for chronic illness may be for a lifetime or recovery period Long term Care services owned by state, federal or local gov't may use tax dollars Government Owned facilities (ex-VA) investor owned and operated by corp or stockholders Proprietary agencies Operated by universities, religious organizations, fraternal groups. All profit above that needed for maint. and operations Non-Profit Agencies must go to improvement and growth Used to describe a client's condition Acuity type of service that is often a special unit in a hospital usually less than 30 days Sub Acute Care 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 refers to care focused on meeting deficits of ADL's Custodial Care provides medical, nursing, social work, spiritual support, for pts and families during a terminal illness Hospice Care designed to restore health and function Rehab care Care is provided and then the patient is discharged soon after Ambulatory Care also called outpatient care care that is provided outside of a health care clinic, hosp. usually provided in the home Home Health Care Med/ Surg, OB, ER and diagnostic center plus lab services General or Community Hospital Level 1 Trauma Center, Burn Center, Oncology, and other levels of care Tertiary care hospital Offers only a particular tyoe of care such as Psych, or Peds Specialty Hosp Places offering healthcare must ne approved by the gov't agency, usually the Dept of Health they need this cert Governmental Approval agencies that seek Medicare/ Medicaid funding must meet specific standards and also have many DEEMED STATUS agencies that Medicare/ Medicaid Certification services need this certification Hosp and nursing homes get this accreditation JCAHO- Joint Commission on Accreditation of Healthcare ORganizations Organization that provides voluntary accreditation. Has a peer-reviewed process CHAP- Community Health Accreditation Program 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) 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 Was able to fight incompetence & obtain decent care for the wounded Civil War soldiers by using influential people in Washington Hannah Ropes used the buildup and excitement of the World's Fair to bring together nurses and form the first nursing organization Isabel Hampton This document defines nursing legally, and the scope of nursing practice is outlined. Nurse Practice Act "The act of utilizing the environment of the patient to assist him in his recovery" Florence Nightingale "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 Defines nursing, describes what nurses do, and provides goals and outcomes of care Nursing Theory A theory is a set of concepts & propositions BLANK that provides an orderly way to view phenomena. Theory defines what nursing is, what it does and the goals and outcomes of nursing care. BLANK Nursing is the synthesis of many theories. BLANK Concepts and Propositions are the structural elements of a theoretical foundation BLANK Nursing is always in a state of change. BLANK Nursing knowledge continues to expand in a multiplicity of ways. BLANK Nurses dervive knowledge through Carpers patterns of knowing 4 empirical (scientific), aesthetic (creative) knowledge, personal knowledge and ethical knowledge. a particular viewpoint or perspective "a worldview" Paradigm the major concepts in a discipline that names the phenomena of concern Meta-paradigm Made up of concepts and propositions THEORIES these are mental images of a phenomenon CONCEPTS this describes the relationship between concepts PROPOSITIONS The structure that links concepts together, representing a unified whole. Conceptual framwork a symbolic representation of a theory, shown through diagrams, words, or notations, Conceptual model This provides an overall framwork for structuring ideas Grand theory This is used to address more narrowy defined phenomena and can be used to suggest an intervention Middle-range theory A meta-paradigm in nursing has 4 areas Person, Health, Environment and Nursing The individual, family or group in a meta-paradigm PERSON The continuum of wellness to terminal illness in the metaparadigm HEALTH The place or community where care is provided in a meta-paradigm ENVIRONMENT The actions; interactions of the nurse with the person in a meta-paradigm NURSING There are 4 levels of KNOWING: empirical, aesthetic, personal, ethical She is recognized as the first nurse theorist. She describe nursing as both an art and science. She recommeded adjusting the environment to improve a person's health. Florence Nightingale She described 4 conservatin principles for nursing, specifically the conervation of energy, structural integrity, personal integrity, and Myra Levine social stability. She also stated people need nursing when they are unable to care for themselves. She developed the theory of Human Caring and described 10 carative factors. Jean Watson 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 She emphasized understanding the person's lived experiences as related to health. Rosemary Parse 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 Hildegard PeplauPeplau's interpersonal P- Focus on the individualthey live in an unsatble relations model *environment not defined equilibrium & strive to reduce anxiety H- Moving toward a directon of beong creative, constructive, productive, & personal and community living N- Sick person and nurse therapeutic communication Virginia Hendersondefinition of nursing P- complete being who has 14 fundamental needs Eaggregate the external conditions & influences HRequires independence 7 interdependence Must be able to do the 14 basics unaided Nto assist those who cannot do by themselves 14 funadmental 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 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 actionsee next card 3 models of action in Leininger's theory culture care preservation, culture care accomidation, and culture care re-patterning Orem's self care theoryDorothea E. Orem P- a unity who can be viewed as functioning biologically, symbolically & socially, and who initiates & performs on thier own to maintain health and well being. H- Well being is used in the sense of the person's percieved condition of existance. Orem's theory regarding Nursing Nursing is a deliberate action, a function of the practical intelligence of nurses & action to bring mundanely desirable conditions. Roger's science of unitary human beings- Martha E. Rogers P- Different from the sum of its parts. Continous repatterning. E- Each is specific to its given human field. H- + health= wellness. 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. Roy's adaption modelSister Callista Roy P- a bio-psycho-social being who is constantly intereacting with the environment & who has 4 modes of adaption H- a state & process of being & becoming an integrated & whole oerson. N- care & well being of humans, rooted in beliefs about the human person Roy's 4 modes of adaption based on physiologic needs, selfconcept, role function, and interdependence 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, menatl, and social functioning. E- social, cultural and spiritual influences of society. Sets goals Watson's theory re: nursingNursing combines the research process witht he problem solving approach & is concerned with promoting and restoring health, preventing illness & caring for the sick. King's goal attainment theory- Imogene King P- 3 interacting systems, the personal systems is unified complex whole self who percieves, thinks, desires, imagines & decides, identifies goals & selects means to achieve it. E- is constantly changing H- continuous adaption to stress to achieve max pote King's theory re: nursinga helping profession that assists individuals & groups in society to attain, maintain, & restore health or to help individuals die with dignity. King;s 3 interacting systems Individuals (personal), groups (interpersonal), and society (social) systems. Neuman's systems modelBetty Neuman P- the total person is mad eof physiologic, socio-cultural & developmental varibales. Epeople maintain varying degrees of harmony & balance H- Illness = lack of harmony among parts & subparts of the system 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 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 HHealth is maintained through preventions of disease from envir. factors. Florenece Nighingale's major concepts of health ventilation, warmth, light, diet, cleanliness, and absence of noise Florence Nightingale's theory re: nursing Provision of optimal conditions to enhace the person's reparative process from being interupted. a set of guidelines for provding high-quality nuring care & criteria for evaluating care Standards of nursing practice who sets the standards for nursing practice The American Nurse Associations Standards of Nursing Practice. 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 stautory law Nurse Practice Acts 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. The creation of the nursing care plan is a ? stage of the nursing process Intermediate- it guides in th ongoing provision of nursing cre & assists in the evaluation of that care. 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 delibrate systematic process -it relates to the future -it is based upon identifiable health & nursing problems 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 Tools or guidelines that diret are by identifying expected outcomes Critical Pathway a plan of care based on standards that reflect Care Map/ clinical pathways optimal timing of sequential steps provided by all members of the team or managing chronic health problems 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 Evidence based practice guidelines integrating individualclinical expertise with the bst available external clinical evidence from systematic research. these may be established for the careof pts with specific illness, treatments, or surgical procedures. Evidence based guidelines components of these gidelines -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 ASSESS, LINK, SYNTHESIZE, DESIGN, IMPLEMENT AND EVALUATE, INTEGRATE AND MAINTAIN ** BLANK** a process that uses observable & verifiable info, colected in a systematic manner to describe, explain, or predict events Research a study in which items can be counted or measured & statistics can be used to analyze the results Quanitative research pure or lab research that is designed to generate & refine theory basic research also called practical research, it is designed to directly influence or improve clinical practice applied research 4 types of quantitive research Descriptive, correlational, Quasi-experimental, and Experimental explores and describes events in real life situations, describing concepts Descriptive Research examines the type & degree of relationships between 2 or more variables Correlational Research examines cause & effect relationships between selected variables. Often conducted in nursing research t examine effects of intervenions on pt outcomes Quasi- Experimental Research examines cause & effect relationships between variables under highly contolld conditions Experiemental Research something that varies and has different values that can be measured Variable the variable being studied, determined as a result of a study Dependent variable causes or conditions tht are mainpulated or identified to determine the effects on the dependent varable Independent variable statement of relationships between the independent & dependent variables that the researcher expects to find Hypothesis info the researcer collects from subjects in the studyexpressed in numbers Data devices used to collect & record the data Instruments the systematic collection & analysis of more SUBJECTIVE narrative materials Qualiative Research which os 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 4 types of Qualiative Research Methods PHENOMENOLOGYdescribes 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 * other 2 methods -ETHNOGRAPHY- examines issues of a culure that are of interest to nursing - HISTORICALexaminesevents of te passt to generate understanding of nursing profession QUANTITIVE RESEARCH -objective - deductive * tests theories - Generalisable -Numbers QUALITATIVE RESEARCH -Subjective -inductive * generates theories -NOT generalisable -Words Keys to critiquing research repors -Source -author -content - consensus 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 recieve. The right to confidentiality, & to be protected from harm any eval of services providd & the results achieved are compared with acceped 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 a medicare/ medicaid review organization that evals preadmission, preprocedure, concurrent or retrospective review. PRO- Peer Review Organization. The purpose is to determine if care given was necessary & appropriate. Outcome Measures are the actual healt results in pts & communities served. key indicators or QI (quality indicators) show effectiveness of the system as a whole & indicate whether access to services are available. include infection rates & morbidity/mortality rates associated with specific hospitals & procedures. Hospital Healthcare Outcomes 3 groups under HCUPHealthcare Cost & Utilzation Project used to determine quality of care & access to care prevention, inpatient & pt safety quality indicators Long term quality indicators there are 11 areas of care ith 24 quality indicators. they represent common conditions & items that are important to residents & serve as te focus for suveyors. Purpose of this was to establish national goals to serve as a focus by individuals, organizaations, & the governmnt. National Health Indicators National Health Indicators do this Process-Identify NeedAssemble Team- Collect datause nursing audits or peer review- establish outcomesEvaluate Risk Management an effort to reduce & assess risks to pts, staff, & organizational assets withina health care institution. They identify risks and review & apprase safety protocols In review & appraisal they do this 1. STRUCTURE EVAL or audit focuses on environment in which the care is provided. Standards describe phyisical facilities & equiptment; organizational characteristics, policies & procedures, fiscal resources, prsonnel resources. They then- PROCESS EVAL which is the nature & sequence of activities carried out by nures implementing the nursing process. Criteria make explicit acceptable levels of erformance for nursing actions r/t pt assessment, dx, planning, implemntation, & 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 LEGAL- addresses tje general welfare of the public. A violation of this law is a called a crime & is prosecuted by the gov't. CRIMINAL LAW This law regulated condeuct between private individuals or businesses & is enforced through the courts as damages or monetary compensation. CIVIL LAW 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 Statue this is published in codes. it is broken down into specific rules. it includes constutional laws and enacted laws Statutory Laws is derived from common usage, custom or judical law. it is based on occurances of events, it is less clear & exact that stauutory law Common law- ( FYIstatutory law & regulatory law carry more weight in court than common law does) these are civil wrongs committed by 1 person against another person or their property. It can TORT- it can also be a crimegross negligance that demonstrates that offender is guilty of complete disregard include physical harm, pychological harm, harm to livelyhood, or some other less tangible value such as harm to repuation. for another's life may be tried as both a civil & a criminal action & is oprosecuted under criminal & civil law. When the outcome is planned, although the person involved may not have believed the outcome would be harmful intentional tort 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. 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 Negligence 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 breech of duty. Breech 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 resonable prudent person. Failure to peform an act required by law or performing in an unlawful way 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 arounds. Therapeutic communication includes; listening, clarifying, & problem solving Elements of Malpractice 1. Harm to an individual 2. Breech of duty b the professional 3. duty of a professional toward an individual 4. breech of duty as the casue of harm intentional & unlawful offer to touch a person in an offensive, insulting or physically intimidating manner. Assult the touching of another person without the person's consent. BATTERY 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 sundproof, sharing pt info, interacting with pt's family re: HIPPA the willful & purposeful misrespresentaion that could cause or has caused loss or harm to a person or property. Fraud- Misrepresentation of a product is a common fraudulent act. an intentional tort in which one party makes Defamation of character derogatory remarks about another that diminish the other party's reputation & is grounds for an award of civil damages written form of defamation libel oral form of defamation slander making a person stay in a place against their wishes False Imprisonment- the law always requires the least restrictive measures in care including with restrainsts (physical or medical) abandonment - each state has different definitions. Nurses cannot leave their patients when they are needed. 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. 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.