Overview of Critical Care Nursing, Exams of Nursing

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Chapter 1-Overview of Critical Care Nursing

Critical care Nursing - -Human responses to life threatening problems, critical illnesses or injury (Physiological/psychological) -Focus on both patients and family's responses -Recovery Rooms -Coronary Care Units - The first critical care units in 1960: Electronic Intensive Care Unit (eICU) - -Patients monitored by critical care nurses and physicians -Reduced hospital and ICU lengths of stay -Reduced mortality -Acutely ill patients with high-technology require American Association of Critical-Care Nurses (AACN) - -Established in 1969 -Supports critical care nurses -Largest Nursing specialty organization in the world -Provides knowledge and resources to those caring for acutely and critically ill patients -Focuses on assisting acute and critical care nurses to attain knowledge and influence to deliver excellent care Synergy Model - -AACN's Vision -Supports a health care system driven by needs of patients and families Society of Critical Care Medicine (SCCM) - -Founded in 1970 -Receive care from a multiprofessional team directed by intensivist (physician who has education & training in management of critically ill and board certified) -Multiprofessional scientific and educational organization

-To secure highest-quality care for all critically ill and injured patients Competencies of Nurses Caring for the Critically Ill - -Clinical Judgment & reasoning skills -Advocacy and moral agency -Caring Practices -Collaboration with patients, families and health care team -Systems thinking promoting holisitic nursing care -Response to diversity -Facilitator of learning for patients and families, team members and community -Clinical Inquiry and innovation to promote best patient outcome Society of Critical Care Medicine (SCCM) - The __________ is dedicated to ensuring excellence and consistency in critical care practice through education, research, and advocacy. 1-CCRN 2-PCCN - The certifications for nurses in acute and critical care bedside practice are known as _______ and ________. 1-CCRN 2-CCRN-E - The __________ certification is available for nurses who provide care of critically ill adult, pediatric, or neonatal populations. The __________ credential is available for nurses working in eICUs. PCCN - The ___________ is for nurses who provide acute care in progressive care, telemetry, and similar units. ACNPC-AG - Acute care nurse practitioners can become certified as _______________ Standards - -Serve as guidelines for clinical practice -establish goals for patient care and provide mechanisms for nurses to assess the achievement of patient goals, regardless of the setting for practice -Delineate Nursing Process Standards of Practice - -Evaluate quality of nursing practice -Evaluate own practice

-Acquire knowledge and maintain competency -Contribute to professional development of peers -Act ethically -Use skilled communication -Use clinical inquiry -Consider factors related to safety, effectiveness and cost -Provide leadership in clinical setting -Technical Competence -Relationship Building with patients & families -Ability to multitask and set priorities - Critical care nurse characteristics: Quality and Safety Education for Nurses (QSEN) - The __________ provides a road map for integrating quality and safety principles into prelicensure nursing education -patient-centered care, teamwork and collaboration, evidence-based practice, quality improvement, informatics, and safety. Rapid Response Team (RRT) - The goal of a __________________ is to identify and manage both unstable patients and those at high risk for cardiopulmonary arrest to prevent unnecessary deaths. -Critical care nurses are often the leaders on such teams. -Communication -Medication Safety -Reconcile medications -Reduce infections - The Joint Commission National Patient Safety Goals 1-Accuracy of Patient Identification 2-Communication 3-Medication safety

4-Alarms safety 5-Reduce risks of health care-associated infection 6-Identify safety risks 7-Prevent complications associated w/ surgery and procedures - Examples of Patient Safety Goals: hand-off - Communication breakdowns often occur during ____________ situations, when patient information is being transferred or exchanged -Physicial Setting- (background noise, lack of Privacy, interruptions -Social Settings-(organizational hieracry and status issues) -Language-(Differences between people of varying racial and ethnic backgrounds or geographic areas) -Communication medium-(limitations of communications via telephone, email, paper or computer) - Barriers to Effective Hand-off Communication Ask-Tell-Ask - A strategy for encouraging nurses to assess concerns before providing more information, especially when discussing stressful issues with patients and families Tell Me More - A tool that encourages information sharing in challenging situations, and the situation, background, assessment, recommendation (SBAR) approach is useful in communication, especially with physicians SBAR - The _________ technique delivers information in a way that is brief and action oriented 1-State what is happening at the present time that has warrented the SBar Communication 2-Explain circumstances leading up to this situation. Put situation into context for the reader or listener 3-State what you think is the problem 4-State your recommendation to correct the problem - Situation- Background- Assessment- Recommendation- Crew Resource Management (CRM) - Promotes communication and accountability among team members

Culture of Safety - A nonhierarchic culture in which all members have the opportunity and the duty to ensure safe and effective care. 1-Performance - Hospitals are often reimbursed based on ______________ and do not receive reimbursement to treat complications that may result from treatment Point-of-Care - _______________ laboratory testing is done at the bedside to provide immediate values to expedite treatment. Universal Care - The _____________________ model eliminates the need to transfer patients to other units and promotes continuity of care 1-participation in nursing organizations 2-Regularly reading print and online journals 3-Attending continuing education offerings - The best ways to influence practice in an ever-changing environment is through: -Collaboration -Communication -Authentic Leadership -Meaningful Recognition -Appropriate Staffing -Effective Decision making - Healthy Work Environment Initiatives