Foundations for Medical-Surgical Nursing: Evidence-Based Practice and Competencies, Exams of Nursing

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Chapter 1 Foundations for medical-

surgical nursing Questions and Answers

Evidence-based practice - is the foundation of professional nursing practice. Based upon a problem-solving approach to health-care delivery, nursing care practices and protocols are based upon the best evidence from research studies and the expertise of clinicians. Steps of Evidence-based practice - *Develop the question *Search and collate the best evidence *Evaluate the quality of the evidence *Integrate evidence into practice *Evaluate outcomes of practice change *Disseminate the evidence Time-outs - Requires all personnel involved in the procedure to stop to make sure that the patient is identified, the correct anatomical site is identified, and all equipment is in working order, and special procedures for marking surgical sites.

Medical-surgical nursing has historically been practiced in acute care facilities across the US. Medical-surgical nursing is now practiced in many different practice settings including

Hospitals Same-day surgical centers Acute rehabilitation centers Ambulatory care settings Long-term care agencies Patient homes Medical-surgical nursing focuses on the management of acutely ill adult patients. Medical-surgical nurses are the largest group of practicing nursing professionals. Academy of Medical-surgical nurses (AMSN) - The professional nursing organizasion for medical-surgical nurses, the foundation of all nursing practices has its roots in this practice area. (medical-surgical nursing that it) Medical-surgical nursing certification board(MSNCB) -

Over the years, medical surgical nursing has developed into a specialty practice area, and RNs who meet requirements are eligble for certification in medical-surgical nursing. These nurses earn the credential Certified medical-surgical registered nurse. (CMSRN) American Nurses Credentialing center (ANCC) - Another available certification in medical-surgical nursing where nurses are given the credentials Registered nurses-board certified(RN-BC) Entry-level nursing programs, including associates, bachelor, and master (including clinical nurse leader), and doctoral degrees - Focus on the preparation of nurses to practice competently in the various medical- surgical settings. Competencies Related to the Nursing Process - Important to the practice of medical-surgical nursing:Competencies in the nursing process, clinical decision making, evidence based practice, patient-centered care, quality and safety, and interprofessional practice. American Nursing Credentialing center (ANCC) Magnent Recognition Program - Awarded to health-care facilities that demonstrate excellence in the recruitment, recognition, and retention of nursing staff as well as excellence in patient care and quality. Because quality patient care is associated with a foundation i evidence-based practice findings, the ASMNS scope of medical-surgical nursing practice provides dissemination of evidene-based practice guidelines for medical-surgical nurses. Medical-surgical nursing - A specialty area characterized by competencies that are applicable for patients across the health-care continuum from acute care hospitals to home setting. The largest subspecialty in nursing, medical-surgical nurses are eligible for certification in this practice through AMSN or ANCC. Patient-centered care - Importance is demonstrated by its incorporation into TJC's accreditation standards for hospitals. Interprofessional coordination and teamwork are also essential to effective patient outcomes in the complex health system in the US. Medical-surgical nurses work closely in interprofessional teams including providers, social workers, pharmacists, and other disciplines to plan and implement the best evidence-based practice. SBAR - One approach to decreasing communication barriers and focuses on a standard way to state the situation, background, assessment, and recommendation. SBAR Approach to effective communication - Situation- Brief statement of the problem or issue being addressed. Background- Data related to the current situation.

Assessment- Summary of causes, significance, severity of situation. Recommendation- Specific actions needed to address the situation. The SBAR approach method provides a consistent process for communication, particularly in high-risk situations. Of particular value is the focus on making a recommendation that focuses on a definite approach to addressing the issues or clinical problem. Which factors have led to the expansion of medical-surgical nursing from traditional acute care facilities to other settings?Select all that apply A. Increase in health-care complexity. B. Shortage of RN's C. Changes in insurance coverage D. Shortened hospital lengths of stay E. Low salaries for RN's in hospitals - A, C, D. Rationale: changes in healthcare delivery, legislation, and insurance coverage, have led to medical-surgical nursing being practiced in many different practice settings, including hospitals, same day surgical centers, acute rehabilitation centers, ambulatory care clinics, long term care settings, and patients' homes The medical-surgical nurse implements SBAR to promote effectiveness in which aspect of quality and safety in patient care? - Communication Which outcome of interprofessional teams is associated with the increased focus on educating health professional students together? - Increased safety and quality The medical-surgical nurse needs to be knowledgeable of which organization that scores patient-centered care via a telephone survey of selected patients after discharge? - Hospital consumer assessment of healthcare providers and systems (HCAHPS) In designing an evidence-based practice guideline for a medical-surgical unit, which source provides the most reliable information? - Results from research studies Academy of medical-surgical nursing nurses strategic framework -

Mission: To promote excellence in medical-surgical nursing. Vision: MedSN use their powerful voice and focused action to continually improve patient care.

Values: MedSN is distinct specialty with its own body of knowledge. We believe patients receiving better care when MedSN: *Engage in ongoing professional development *Use evidence based practice *Speak with a unified voice *Serve as leaders on health care terms *Have the necessary resources to deliver excellent care *Practice in a healthy work environment. Strategic Message The AMSN is a vibrant community of medical-surgical nurses who care about: *Improving patient care *Developing personally and professionally *Advocating for the specialty of medical-surgical nursing *Connecting with other nurses who share their connection and commitment.