Download Interprofessional Collaboration in Healthcare and more Exams Nursing in PDF only on Docsity!
NURS 2030 exam 3 answers 2024
collaborative health care - ANS client-centered approach in which members of different health care professions come together and work toward common goal of improving or restoring a client's health more managing problems to optimal levels interprofessional team and benefits - ANS 2 or more professionals working together improved access to and coordination of health care services greater efficiency of client referral and client-care services (get where they need to) increased quality of community health services decrease in complications, length of stay, sentinel events, mortality, and staff turnover parts of interprofessional team - ANS primary care physician dietician hospital specialty physician lab, radiology, pharmacy nurse case manage interprofessional education collaborative (IPEC) - ANS values and ethics roles and responsibilities communication teams and teamwork values and ethics - ANS Maintaining a climate of shared value, ethical conduct, and mutual respect roles and responsibility - ANS use the knowledge of one's role and team member's expertise to address health outcomes
communication - ANS communicate in a responsive, responsible, respectful, and compassionate manner includes body language teams and teamwork - ANS apply values and principles of the science of teamwork to adapt in various settings when to use IPE team - ANS rounding--docs, residents, students, pharmacists, nurse referrals consultations discharge planning discharge teaching consultations - ANS when one provider formally requests another provider's input or advice about how to approach or treat condition ex. requesting pt for patient (Nurse talks to doc) ex. hospitalist sees heart issues with patient so consult cardiologist referral - ANS when provider delegates responsibility of management of the client's specific condition to another provider more follow up ex. patient is discharged but refer to cardiologist discharge planning - ANS systematic process of preparing the patient to leave the health care facility and for maintaining continuity of care discharge starts when admitted discharge teaching - ANS use teach-back to ensure client and fam understand encourage client to ask questions instruct on essential points... essential points on discharge teaching - ANS how to administer prescribed meds dietary and activity limitations
dietitian - ANS monitor weight and nutrition status therapeutic diets recommend supplements: help out with patients that aren't eating/not eating enough nutrients tube feeding consult and calculate rate Licensed Practical Nurse (LPN) - ANS one year program work under RN or APRN gather data, some treatments, administer some meds can't interpret data occupational therapist - ANS focus on ADLs fine muscle movements: getting dressed, brushing teeth/hair, eat have adaptive equipment Emergency Medical Technician (EMT) - ANS administer care and stabilize conditions to transport care limited resources; cannot do everything hospital can do may transport patient home, etc always communicate and sign paperwork goal: get to ER alive paramedics - ANS more training, more interventions/drugs speech therapist - ANS improve speech and language literacy, fluency, comprehension muscles in mouth--> swallowing barium swallow, evaluation pharmacist - ANS help with all med orders
communicate, ask if unsure about order/medication can decide dosage based on labs records can give nutrition thru veins if cannot PO side effects, interactions physical therapist - ANS walking, standing larger range of motion physician - ANS diagnostics, what's wrong?, what do we do? residencies, boards work with not against you can advocate for patient's care physician assistant - ANS treat, diagnose, prescribe meds/labs work with physician any area where you see NPs round before physician respiratory therapist - ANS experts in lungs, airway help clients with acute or chronic conditions of the lung breathing treatments, oxygen devices, CPAC, ventilations in charge of secretions keep airways clear registered nurse - ANS biggest member of IPE team at bedside for 12 hours eyes and ears for patient relaying info to doc, NP, etc
5 rights of delegation - ANS 1. Right task
- Right circumstance
- Right person
- Right direction/communication
- Right supervision/evaluation right task - ANS delegate task to appropriate levels of team members based on standards of practice, legal and facility guidelines in scope of practice? appropriate for person? *make sure does not involve clinical judgment if not delegating to nurse right circumstance - ANS Appropriate patient setting, available resources, and other relevant factors considered is client stable? right person - ANS Right person is delegating the right task to the right person to be performed on the right person right education? right directions and communication - ANS clear instructions, exactly what we need, closed loop communication right supervision and evaluation - ANS if need help/ask for assistance follow up to make sure task is complete who to delegate to--assistive personnel - ANS basic care with no assessment, routine tasks noninvasive procedures: skin care, ROM exercises, ambulation, grooming, hygiene who to delegate to--LPNs - ANS can perform tasks of assistive personnel care for stable clients some invasive tasks: dressing changes, suctioning, urinary catheterization, med administration (some), collect data and review teaching plans created by RN *nurse often does 1st assessment of day then LPNs
care transitions and continuity of care - ANS increasingly complex helped by use of EHRs: pull up records easily make sure communicating with team especially when transporting transitions can make care suffer eHealth information exchange - ANS payers, patient, government, community hospital, academic medical center, specialty practice, pharmacy, primary care physician, labs, independent health facility, other HIE communication with health care team--breakdowns occur during - ANS client handoffs (ex. EMT to nurses & dr in ER staff/shift changes failing to establish clear cut responsibilities communication with health care team--to improve: - ANS closed-loop communication, delegation, follow up clear, concise info, minimize interruptions, don't multitask standardized communication tools, terminology and procedures called at hospital ISBARR - ANS introduction, situation, background, assessment, recommendation, read back/questions ISBARR paper - ANS handoff report - ANS use ISBARR info, at bedside when possible a nurse or provider hands over the care of a client to another nurse or provider things that can be reported - ANS background allergies medication regimen condition/code status anticipated needs
hierarchy bullying - ANS recurring behavior involving unwelcome actions intended to harm, humiliate, or distress another nursing informatics - ANS the use of information and technology to communicate, manage knowledge, mitigate error, and support decision making marrying tech with nursing to improve workflow and patient outcomes types of informatics used in nursing - ANS simulation clinical information systems: includes information technology and EHR simulation - ANS safe space for learning and application...treat like clinical, evaluations clinical information systems - ANS computer system that allows for instant retrieval of client info either directly or from data networks see informatics: barcode scanning, documentation data information technology - ANS technology and physical devices used to create and store info vital signs, create data --> charting system electronic health record - ANS real-time computerized form of a client's paper chart that can be shared among providers clinical pathways - ANS process--improvement map care maps or integrated pathways decision support tools that outline specific steps to a predetermined clinical problem standardize care, decision making, eliminate errors, EBP ex. migraine treatment *every patient is different HIPAA and confidentiality - ANS federal law enacted to safeguard client's medical health info when it is being accessed or shared electronically without the client's consent or knowledge
90: cannot give specific age privacy rule - ANS protected health info (PHI) any information heled by a covered entity for healthcare that can be linked to an individual unique client identifiers which can link a client to their PHI be coded rights about public health info limits with info used specific set of rules patient's have access to medical records patient health identifiers - ANS names, geographical data smaller than a state, dates directly related to client, telephone #, fax #, email addresses, SSN, MR numbers, health insurance plan beneficiary numbers, account numbers, certificate/license numbers, vehicle identifiers, device identifiers and serial numbers, web URLs, IP addresses, biometric identifiers (ex. fingerprint), full face photos aspects of nursing informatics to consider - ANS security rule breach notification rule enforcement rule security rule - ANS specifically addresses the use and disclosure of electronic PHI increased phones, security breach notification rule - ANS covers the process of reporting and responding to each breach of PHI something share that should not be...how does the hospital proceed? enforcement rule - ANS includes compliance and investigations, the administration of penalties for violations of HIPAA rules, and procedures for the investigation of these violations civil $ penalties...how much owed to patient for breach of HIPAA social media in nursing informatics - ANS client confidentiality and privacy extends to social media
lab reports diagnostic testing assessment problem-oriented medical records - ANS gathers information from all members of interdisciplinary team database to chart assessments problem list in chrono order initial plan with goals, outcomes types of documentation: SOAP notes, PIE model 1 continuous story: more for other providers not nurses SOAP notes - ANS subjective, objective, assessment, plan PIE model - ANS problem, intervention, evaluation charting focus charting - ANS documents a client's specific health care problem by focusing on the nursing diagnosis as well as changes in the client's condition, events, and concerns Data, Action, Response medication administration and EHR - ANS NPSG: improve safety of using medications med reconciliation (meds taken outside hospital) adverse drug event medication error adverse drug event - ANS an injury caused from a medical intervention that is linked to a medication ex. sleeping meds causes them to fall medication error - ANS Preventable error capable of causing harm or death to a client under the care of a health care provider. phases of medication admin error - ANS ordering
transcribing dispensing administration ordering - ANS wrong: dose, meds, patient transcribing - ANS putting order in ex. 4 mg vs 4 g dispensing - ANS wrong meds in wrong slot/bottle administration - ANS EHR can reduce human error but nurse is still accountable giving right meds documentation in the EHR - ANS 40% of time spend by health care workers during shift provides complete, accurate, and timely documentation professional and legal necessity legible clinical alerts sometimes does not work--have to chart by hand documentation guidelines - ANS Factual Accurate Complete Timely factual - ANS direct observations, measurements, med terms ex. client's head is round, symmetrical, and normocephalic. no nodules or depressions present when palpated
nursing students - ANS regulated by state board of nursing accreditation by commission for education in nursing (ACEN) and commission on collegiate nursing education (CCNE) quality and safety education for nursing (QSEN) - ANS based on IOM's core competencies for all health clinicians; interwoven into essentials nurse specific-competencies created by QSEN faculty and advisory board 6 competencies - ANS Patient-Centered Care Teamwork and Collaboration Evidence-Based Practice Quality Improvement Safety Informatics NLN (National League for Nursing) Integrating competencies - ANS foster excellence in nursing education 4 core values strong and diverse workforce to increase health of our nation 4 core values - ANS professional identity human flourishing nursing judgment spirit of inquiry AACN essentials - ANS 10 domains-in notes initial licensure - ANS NCSBN creates NCLEX standardized and adaptive exam to determine if candidate is safe to practice as an entry-level nurse once a student has passed regulatory requirements by SBON, they can get authorized to take NCLEX
nurse ACA - ANS continuing education for licensing renewal, practice hours, criminal record professional nursing organizations - ANS • American Nurses Association (ANA)
- Sigma
- American Academy of Nursing
- National League for Nursing (NLN)
- Specialty organizations student organizations - ANS national student nurses' association american nurses association sigma american association for men in nursing american association of colleges of nursing code of ethics - ANS the ideals, duties, and obligations that nurses are expected to uphold as members of nursing profession applies to licensed nurses and nursing students designated by ANA's Code of Ethics ANA's Code of Ethics - ANS provisions 1-3: fundamental values of nursing profession provisions 4-6: duty and loyalty to clients and themselves provisions 7-9: duty and loyalty that nurses show beyond direct client encounters and nursing profession ethical principles - ANS Autonomy Beneficence Nonmaleficence Veracity Fidelity Justice autonomy - ANS self-governance nurse's obligation to respect the client's right to make their own decisions regarding their health care, including the right to refuse
being an advocate for your patient nurse helps despite risk to themselves **too much can lead to burnout human dignity - ANS Implies that each individual, regardless of things such as race, religion, sex, gender, etc., has value and shall be respected simply because human beings are all equal nurses should: maintain privacy and autonomy show respect provide culturally competent care ensuring confidentiality integrity - ANS when a nurse demonstrates honesty, even when circumstances challenge the nurse's character can be difficult to sustain speak up! Ethical Decision Making - ANS 8 steps step 1 - ANS is there an ethical dilemma? step 2 - ANS clearly identify ethical dilemma step 3 - ANS identify possible solutions step 4 - ANS apply ethical principles to solutions step 5 - ANS include all relevant individuals and factors step 6 - ANS decide on solution step 7 - ANS review the decision step 8 - ANS put the decision into action ethical dilemmas - ANS occur when the personal values of the nurse are different from those of client important to stick to code of ethics, regardless of personal beliefs or values
treat patients with respect, advocate consult ethics team if necessary ethical issues faced by nurses - ANS - stem cell research
- late termination of pregnancy
- medically assisted death
- refusal or termination of care/treatment
- care for clients who have substance disorder
- clients who have experienced abuse
- care of clients in legal custody
- allocation of scarce resources informed consent - ANS permission to provide care given by client after relevant information is provided must be given by client or legal representative voluntarily, without coercion by others we do not explain procedures, providers have to before we get consent! ex. surgery, blood transfusion, bone marrow biopsy, some meds what should be included in informed consent: - ANS procedure/treatment provider purpose/expected outcomes benefits, risks any alternatives implied consent - ANS the client is not required to expression permission for care, an intervention, or activities, verbally or in writing the client can withdraw at any time most nursing consents are this; talk through procedure ex. drawing blood advanced directives - ANS legal documents in which a client's decisions related to health care are documented
