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NURS 110 FINAL EXAM STUDY GUIDE Accountability/Responsibility/Liability Accountability: if you forgot to do something then you write yourself up Responsibility: if you notice something was not done and someone else made an error then you report it Liability: © Elements include: duty, breach of duty, causation, and damages @ All four of these must be present for someone to be liable for something Credentials Credentials: ways in which professional competence is ensured and maintained Know the credentials of the people that you work with Licensure: nursing license Accreditation Certification: given to a person who has met certain criteria established by a nongovernmental association and is granted recognition in a specified practice area m Ex: speciality knowledge, experience, and clinical judgment Scope of Practice loxexeke) Critical Thinking/Clinical Reasoning/ Clinical Judgement Critical Thinking: when you take different pieces of information and apply it to a clinical situation © Use your base of knowledge Clinical Reasoning: the analysis portion. You have the data and you are in the process of applying it © The process Clinical Judgment: when you have finished critical thinking and clinical reasoning and make the judgement Documentation and Reporting Sentinel event = patient safety event that reaches a patient and results in death, permanent harm, or severe temporary harm Event Report © Use only objective and factual language © Report only facts © Must be concise Advance Directives O DNR © No advance directive = full code © Advance directive is a legal document m@ You write down who you want to make decisions for you m Allows you to indicate the type of treatment you want if you are not well enough to make decisions yourself m Write down what you do and don’t want medical professionals to do @ Helps plan future medical are co Types of advance directives @ Durable power of attorney/healthcare proxy Bi Living will © Patient must always sign authorizations to have their information released NANDA Diagnosis Types Actual This is a PRIORITY 3 part statement Address an actual problem that the patient is having in that moment NURSING INTERVENTIONS: fix the problem Ris! This POTENTIAL “At risk for” diagnosis speaks to the RISK that the patient may encounter May not have happened yet You cannot be at risk for infection if you have an infectious process currently happening There are no related factors since we are identifying a vulnerability in a patient for a potential problem; the problem is not yet present NURSING INTERVENTIONS: prevent the problem Oo O0O00007%70000 NANDA statement content NANDA diagnosis represents the patient’s response to their condition or their treatment Statements always start with a NANDA To use the diagnosis, the defining characteristics must be present, there must be an altered physiological response and they list what they can be As Evidenced By (AEB): these are things YOU SEE or the patients REPORTS and they are LISTED in the book Nursing Process (ADPIE) The nursing process is essentially the process of applying the scientific method to caring fora patient 5 steps: Assessment, Diagnosis, Planning, Implementation, Evaluation (ADPIE) The process is continuous and dynamic so that you may move back and forth among steps Nursing assessment helps nurse to: © Form a clear definition on the patient’s problem which in turn provides the foundation for m Planning and implementing nursing interventions an evaluating the outcome so fcare Nursing process = standard of practice, which, when followed correctly, protects nurses against legal problems related to nursing care ADPIE o Assessment m From the patient, head to toe assessment, vitals, collect history m LOOK, LISTEN, FEEL ™@ Contains 2 stages = collocation and verification of data & analysis of data @ Data History and physical History of present illness Results of diagnostic tests What is in the chart Physicians orders Medical records © Diagnosis Identify the problem through a nursing diagnosis o PlaniGoal m Smart goal: @ Specific @ Measurable @ Attainable @ Realistic @ Timely co Implementation/Intervention Take action to meet the goal o Evaluation @ Determine if the goal is met or not Patient Advocacy Advocacy is the protection and support of another’s rights © Important because of patients’ changing expectations and demands You must give priority to the good of the individual patient rather than to the good of society in general When respecting autonomy, the nurse supports the patient’s right ro make decisions with informed consent Patient-centered Care The components of thoughtful practice are all interrelated and function together to create thoughtful, person-centered care © Includes the @ Nursing process (ADPIE) @ Clinical reasoning, judgement and decision making @ The nurse’s personal attributes, knowledge base, clinical experience, blended competencies, QSEN competencies m Reflective practice leading to personal learning Nurses who practice patient-centered care are committed to developing caring professional relationships based on respect and mutual trust Caring is viewed as universal and is practiced through interpersonal relationships Prioritization Deciding which needs or problems require immediate action and which ones could tolerate a delay in action until a later time because they are not urgent Prioritization in a clinical setting > envisioning clearly patient outcomes but also includes predicting possible problems if another task is performed © One must also weight potential future events if a task is not completed The 4 P’s: purpose, picture, plan and part Three levels of priority setting: © 1. ABCs plus vitals and lab values that can be life threatening © 2. Mental status changes, untreated medical issues, acute pain, acute elimination problems, imminent risks © 3. Health problems other than the first 2 levels including long-term issues Protected Health Information PHI = any information in a medical record that can be used to identify an individual that was created, used, or disclosed in the course of providing a health care service, such as a diagnosis or treatment Regulatory Requirements Nurse Practice Act © Nurse is expected to care for patients within defined practice limits © These acts list the violence that can result in disciplinary actions against a nurse and also intent to prevent untrained or unlicensed people form practice nursing Joint Commission © Files an annual list of National Patient Safety Goals @ Established based on sentinel events that have been reported and include the corrective actions recommended as a response to these sentinel events © Joint Commission gives accreditations Hospital policy & procedures Rights of Delegation (FIVE RIGHTS OF DELEGATION) Right Person © The person must be competent © Must be within the scope of practice Right Task © THE FOUR Ps (PURPOSE, PICTURE, PLAN, AND PART) © Task is appropriate to the person’s scope of practice - person has to have the specific qualifications Right Circumstance © The patient should be stable because if they aren’t then you should keep the task to yourself Right Direction & Communication © If you're not sure, ask someone © Make sure someone is comfortable doing something and if they are unsure then you can delegate and have them do something else © Should include clear, concise instructions/expectations Right Supervision & Evaluation © It is your job to supervise © If not done right - it is your job to fix it, teach them, do it again © If you’re delegating, you are acknowledging that at the end of the day you are accountable and everything is your responsibility Theory/Theorists NURSING Central Theme & Application to NURSING | Central Theme & Application to Practice THEORIST Practice THEORIST Florence | -environmental theory Imogene _ | -goal attainment theory Nightingale | -asepsis and infection control King -nursing is a process of human interactions as patient and nurse set 8 Hildegard | -psychodynamic nursing Betty -health care systems model Peplau -understand own behavior to Newman | -must maintain balance and harmony help others identify their between internal and external difficulties environments. -person lives in unstable -constant relationship with stressors equilibrium Virginia -nursing practice is independent Sister -adaptation model Henderson | -autonomous nursing Callista | -5 interrelated essential elements -patient needs help to Roy (patiency, goal of nursing, health, independence environment, direction of nursing activities) Faye -21 nursing problems Madeleine | -culture care diversity and universality abdulslah_ | -physical, social and emotional Leninger | -goal of nursing is to provide care problems congruent with cultural values, beliefs, and practice IdaJean | -deliberative nursing process Jean -philosophy and science of caring Orlando -nurse reacts to verbal and Watson | -nursing concerned with promoting nonverbal and restoring health, preventing illnesses -caring practiced through interpersonal relationships Ernestine | -helping art of clinical nursing Margaret | -health as expanding consciousness Wiedenbac | -providing nurturing care to the Newman | - reduce stress factors h patients -use total-person approach to maintain wellness Lydia Hall | -The core, care and cure Dorothy | -behavioral systems model -major outcomes of nurse care is Johnson | -7 subsystems rehabilitation and feelings of -nurse interventions are designed to self-actualization support/maintain health, educate and modify behavior Myra Levine | - conservation Rosemarie | -human becoming theory - 4 principles= conservation of Parse -health is continual, open process energy of the PT, conservation of structural integrity of the PT, conservation of the personal integrity of the PT, conservation of the social integrity of the PT Martha -unitary human beings Nola - health promotion model Rogers -energy fields Pender | - focuses on individual -emphasis on science and art characteristics and experiences, behavior-specific cognitions and affect, and behavioral outcomes Dorothea | -self-care model Patricia | -from novice to expert Orem Benner & | -5 levels of nursing experience= Judith novice, advanced beginner, Wrubel competent, proficient, expert 10 QSEN Competencies/Blended Competencies 11 e Duty: an obligation to use due care and is defined by the standard of care appropriate for the nurse-patient relationship Breach of Duty: failure to meet the standard of care Causation: most difficult element to prove and shows that the failure to meet the standard of care actually caused the injury 13 NURS 110 Final Exam Study GuideNURS 110 Final Exam Study GuideNURS 110 Final Exam Study GuideNURS 110 Final Exam Study Guide e Damages: the actual harm or injury resulting to the patient Teaching Concepts @ Patient education - the process of influencing the patient’s behavior to effect changes in knowledge, attitudes, and skills needed to maintain and improve health © Must be ongoing and interactive and developed with the entire health care team @ The basic purpose of teaching and counseling is to help patients and families develop the self-care abilities they need to maximize their functioning and quality of life @ Counseling - provides the resources and support that patients need to participate actively in self-care and to facilitate their coping with their circumstances Learning Needs Assessment and Rationale @ STEP 1: Learning Needs Assessment © Learning needs = the gap between the learner’s current level of knowledge and skills and the level of knowledge and skills required to perform a task or a set of tasks or behaviors m= A needs assessment is a systematic process of identifying a gap in: knowledge, skill or practice that answers the question: “will education fix this problem?” m As nurse educators, a needs assessment should form the basis from which all education is planned, developed and implemented = Howto assess the learning needs e Identify the learner and choose the right setting Collect data about and from the learner Involve members of the healthcare team Prioritize needs Determine the availability of educational resources Assess demands of the organization e Take time management issues into account m= Make sure that the proposed behavioral changes are realistic and explored in the context of the patient’s resources and life style m= Decide which domain of learning is involved: e Cognitive: mental skills (knowledge & thinking) e Affective: growth in feelings or emotional areas (attitude or self & feelings) e Psychomotor: manual or physical skills (doing) e STEP 2: Diagnosis © Diagnose the patient’s learning needs and be realistic © Validate with patient or family through conversations, questionnaires and checklists e STEP 3: Planning and Development of a Teaching Plan © Develop learning outcomes and objectives — identify specific attainable, measurable, short-term and long-term outcomes for patient learning STEP 4: Implement Teaching Plan STEP 5: Evaluate Learning e WHERE DO Yt PUT THIS - Maslow’s hierarchy of n © Perspective on motivation © Each person has basic needs (food, shelter, love, etc.) that must be met before learning can occur © They are listed from the bottom (most important) to the top 14 NURS 110 Final Exam Study GuideNURS 110 Final Exam Study GuideNURS 110 Final Exam Study GuideNURS 110 Final Exam Study Guide © About the art and science of how adults learn = Love and belonging needs @ Self-esteem needs (feeling respected, valued, and appreciated) @ Self-actualization (achieving one’s potential) Educational Theory (Knowles Adult Learning) @ Andragogy (Malcolm Knowles created this theory) © Comprised of core adult learning principles that apply to all adult learning situations © 6core principles of andragogy 1. The learner’s need to know 2. The learner's self-concept 3. The role of the learner’s prior experiences 4, Readiness to learn 5. Orientation to learning 6. Motivation to learn Learning Style (Generational/Preferences) YEARS Silent (1925-1945) Boomer (1946-1964) Gen X (1965-1980) Millennial (1981- 2000) Other names] veterans/traditionalists| Conscious Lost generation Generation generation/me Y Echo generation boom Learning -like traditional -enjoy -self-reliant -team oriented, Preferences | structure working -like feedback like group work -will not contradict creatively -online learners -multitask and instructor in public -sensitive to -often impatient technological -do not like being criticism but adaptable and | experts singled out in -significant informal -goal and discussions personal -value autonomy achievement oriented -prefer to practice experience -technologically -require more alone -like capable structure and -may not ask interaction, -prefer informal mentoring questions discussion, approach to -enjoy active learning -may struggle with group work learning -prefer technology -dislike participative -prefer authoritarian learning learning teachers individually -prefer learning as part of a team Communicati} -formal -in person -direct -email on Style -memo -immediate -texting -voicemail Teaching -emphasize -give time to -may resist group | -present in steps Strategies important points practice work -use up to date tech -big font -large font -give -Make learning -encourage -no role-playing individual relevant periodic -team projects attention -encourage creativity NURS 110 Final Exam Study GuideNURS 110 Final Exam Study GuideNURS 110 Final Exam Study GuideNURS 110 Final Exam 16 movement while -group leaders -short lectures -give teaching -well-organized -Working in small | supplemental material groups reading -graphics 17 NURS 110 Final Exam Study GuideNURS 110 Final Exam Study GuideNURS 110 Final Exam Study GuideNURS 110 Final @ The clients motivation to seek further instruction from written sources may be reduced 19 NURS 110 Final Exam Study GuideNURS 110 Final Exam Study GuideNURS 110 Final Exam Study GuideNURS 110 Final 
