R&S3 breakdown - Exam 3 answers (used on actual exam) PDF

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Exam 3 answers (used on actual exam)...

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Role and scope exam 3 Study online at quizlet.com/_423l1c 1.

What are the recommendations for nurses that are published in the IOM's report The future of nursing?

● Nurses should practice to the full extent of their education and training. ● Nurses should achieve higher levels of education and training through an improved education system that promotes seamless academic progression. ● Nurses should be full partners, with physicians and other healthcare professionals, in redesigning health care in the United States. ● Effective workforce planning and policy making require better data collection and information infrastructure. Recommendation 1: Remove scope-of-practice barriers. Recommendation 2: Expand opportunities for nurses to lead and diffuse collaborative improvement efforts. Recommendation 3: Implement nurse residency programs. Recommendation 4: Increase the proportion of nurses with a baccalaureate degree to 80 percent by 2020. Recommendation 5: Double the number of nurses with a doctorate by 2020. Recommendation 6: Ensure that nurses engage in lifelong learning. Recommendation 7: Prepare and enable nurses to lead change to advance health. Recommendation 8: Build an infrastructure for the collection and analysis of interprofessional health care workforce data.

2.

What is Magnet recognition?

The only national designation built on and evolving through nursing research that is designed to recognize nursing excellence of healthcare organizations through a selfnominating, appraisal process.

3.

What are the components of a professional identity in nursing?

First steps, education process and passing state boards (NCLEX) Professional ethics; principles (Rules, codes, standards), Consequences (outcome), virtue (based on character) Continued development Doing and being a good nurse ● High intellectual level ○ Technological ○ pharmacology ○ physical sciences ○ Assessment skills ○ reasoning skills ○ routine judgements ● High level of individual responsibility and accountability ○ Primary care provider ○ can no longer state that the provider ordered it so I did it. ● Specialized body of knowledge ● Public service and altruistic activities ● Well organized and strong representation ● Nurses code of ethics ● Competency and professional license

4.

Who determines laws and rules for professional nurses?

The Nurses Practice Act (State board of Nursing) Laws coming into being is a political process: 3 Branches; Judicial-interprets laws Legislative- represent the people in forming the laws Executive- enforce the laws ● A nurse practice act is a state legislation regulating the practice of nurses that protects the public, defines the scope of practice, and makes nurses accountable for their actions ● Nurse practice acts establish state boards of nursing (SBNs) and define specific SBN powers regarding the practice of nursing within the state ● Rules and regulations written by the SBNs become statutory laws under the powers delegated by the state legislature ● State Board of Nursing: ○ focus primarily on the licensure of nurses w/in their own state (each individual state has its own Nurses Practice Act)

5.

What role do nurses play in informed consent?

Witnesses informed consent. The nurse is responsible for the following. ◯Ensuring that the provider gave the client the necessary information ◯Ensuring that the client understood the information and is competent to give informed consent ◯Having the client sign the informed consent document ◯Notifying the provider if the client has more questions or does not understand any of the information provided. (The provider is then responsible for giving clarification.) ●The nurse documents the following. ◯Reinforcement of information originally given by the provider ◯That questions the client had were forwarded to theprovider ◯Use of an interpreter Consent is required for all care given in a health care facility. For most aspects of nursing care, implied consent is adequate. The client provides implied consent when she complies with the instructions provided by the nurse. For example, the nurse is preparing to administer a TB skin test, and the client holds out her arm for the nurse. ●For an invasive procedure or surgery, the client is required to provide written consent. ●State laws regulate who is able to give informed consent. Laws vary regarding age limitations and emergencies. Nurses are responsible for knowing the laws in the state of practice. ●The nurse must verify that consent is informed and witness the client sign the consent form

6.

What can nurses do to become more professional?

Be active in a professional organization such as: ANA, NLN, or other nursing organization Components of a professional identity in nursing ○ First steps ■ Education ■ Passing state boards ○ Professional ethics ○ Principles ■ Rules ■ codes ■ Standards ○ Consequences ■ Outcomes ○ Virtue ■ based on character ○ Continued development ○ Doing and being a good nurse

7.

What Is a Profession?

● A profession, then, is a type of occupation that meets the criteria of having the following traits: ● High intellectual level ● High level of individual responsibility and accountability ● Specialized body of knowledge ● Knowledge that can be learned in institutions of higher education ● Public service and altruistic activities ● Public service valued over financial gain ● Relatively high degree of autonomy and independence of practice ● Need for a well-organized and strong organization representing the members of the profession and controlling the quality of practice ● A code of ethics that guides the members of the profession in their practice ● Strong professional identity and commitment to the development of the profession ● Demonstration of professional competency and possession of a legally recognized license

8.

Understand the concepts of care coordination and Collaboration in nursing.

Using the nursing process to develop plan of care for patient Effective interdisciplinary teams require collaboration, which is often led by the nurse, who needs to avoid an authoritarian approach. If team members work in an authoritarian environment, they may be hesitant to make decisions for themselves and may fully depend upon the authoritarian leader. Creativity will be dampened, and creativity is mandatory for team progress.

9.

Collaboration in nursing. How does collaboration occur? Who is involved? :

Nurse to Patient Collaboration. Nurses coordinate with patients the many issues surrounding health promotion and disease prevention, treatment methods, lifestyle changes, and end-of-life decisions. Even Florence Nightingale taught collaboration with the patient, assessing what is needed or wanted. Nurse-Nurse Collaboration (Intraprofessional). Nurses work in teams in hospitals, in clinics, and in communities that provide collaboration and support in patient caregiving. Nurses from various units, fields, and with different experiences also collaborate: nurse managers, nurse researchers, nurse educators, advanced practice nurses, as well as novice nurses with expert nurses! Mentoring is one example of this collaboration. Shift "hand-offs" are also exemplars. Interprofessional Collaboration. This is the category that often comes to mind when thinking about collaborative care. Nurses form partnership between a team of health providers from medicine, pharmacy, occupational therapy, physical therapy, dentistry, social work, education, and even law. The ANA code of ethics and QSEN both address interprofessional collaboration as an important part of nursing care. Interorganizational collaboration. Nurses must be aware of and utilize resources and information between organizations which will benefit patients at the local, national, or global levels. Examples of this are Hospice Care at the local level, and Health Care Consortiums at the national level.

● Through respectful communication ● By being open to new ideas ● Involves everyone in the care of the patient ● Involves the family too mutual trust and respect among the members Effective teams participate in effective problem solving, increased creativity, and safe and improved health care 10.

11.

How can nurses work with researchers to improve evidence based practice? How is informatics used to promote interdisciplinary care? How do nurses utilize informatics?

integrate best research with clinical expertise and patient values for optimum care, and participate in learning and research activities to the extent feasible ○ Is the integration of the best research evidence with clinical expertise and the patient's unique values and circumstances in making decisions about the care of individual patients The blending of information and computer science to study processes, management, and retrieval of healthrelated information. Informatics is used to combine data sets to give information, and thus knowledge to the individual using them. Nurses have a defined need to communicate the nursing care of clients and their families, establish comparability of nursing data across clinical populations, project trends regarding nursing care provided and allocation of nursing resources, stimulate nursing research through linkages of nursing data, and provide data about nursing care to influence health policy and decision-making. Health care, the healthcare delivery system, and nursing must open themselves to new information and ideas. Computers are involved in almost every area of client care today from assessment to management to billing. Technologically driven organizations have improved competitive edge

12.

Consider all the forms of communication in nursing practice: nurse-patient, nurse-nurse, etc. Know the different styles of communication: assertive, aggressive, conflictual, & educational.

● Assertive ○ Allows expression in direct, honest and non threatening ways ○ Does not infringe on other's rights ○ it accurately expresses a person's feelings, beliefs, ideas and opinion ○ Assertive communication is the preferred style in most settings. ○ It involves interpersonal behaviors that permit people to defend and maintain their legitimate rights in a respectful manner that does not violate the rights of others. ○ Assertive communication is honest and direct and accurately expresses the person's feelings, beliefs, ideas, and opinions. ○ Respect for self and others constitutes both the basis for and the result of assertive communication. ○ It encourages trust and teamwork by communicating to others that they have the right to and are encouraged to express their opinions in an open and respectful atmosphere. ○ Disagreement and discussion are considered to be a healthy part of the communication process, and negotiation is the positive mechanism for problem-solving, learning, and personal growth. ● How to use assertive communication ○ Maintain eye contact. ○ Convey empathy; stating your feelings does not mean sympathy or agreement. ○ Keep your body position erect, shoulders and back straight. ○ Speak clearly and audibly; be direct and descriptive. ○ Be comfortable with silence. ○ Use gestures and facial expressions for emphasis. ○ Use appropriate location. ○ Use appropriate timing. ○ Focus on behaviors and issues; do not attack the person. ● Aggressive ○ Used to humiliate, control or embarrass the other person ○ Used to lower person's self esteem ○ creates an I win, you lose situation ○ The other person may perceive aggressive behavior or communication as a personal attack. ○ Aggressive behavior and communication are viewed by some psychologists as a protective mechanism that compensates for a person's own insecurities, and others view it as a form of bullying. ○ By demeaning someone else, aggressive behavior allows the person to feel superior and helps inflate his or her self-esteem. ○ Aggressive communication can take several different forms, including screaming, sarcasm, rudeness, belittling jokes, and even direct personal insults. ○ It is an expression of the negative feelings of power, domination, and low self-esteem. Although aggressive people may seem outwardly to be in control, in reality they are merely reacting to the situation to protect their self-esteem. ● Conflictual ○ Communicating in a way that is aggressive and starts a conflict using words like you did this this, what were you thinking. ○ Knowing when a person is at a breaking point and ignoring that or putting someone in that breaking point ○ Arguing for the sake of argument. ○ conflictual communication is often productive, avoiding conflict only defers it and fails to move toward success

○ Being respectful but giving an opportunity to learn ○ Being able to learn when a person needs to communicate about

13.

Understand teamwork in healthcare

Multiple health disciplines with diverse knowledge and skills who share an integrated set of goals and who utilize interdependent collaboration that involves communications, sharing of knowledge and coordination of services to provide services to patients and their caregiving systems

14.

What does an effective team need?

Collaboration! Working together in a respectful civil manner; providing input that generates positive outcomes for patient Participate in effective problem solving, increased creativity, and safe and improved healthcare

15.

What is active listening?

Postponing judgement about what is being said and listening to ALL that is said. Listening is the greatest tool for communicating ● Guidelines for active listening include cultivating a desire to learn about the other person ● Show attentiveness through eye contact and body language ● Postpone judgment about what is being said and listen to all that is said ● Shows you are compassionate, honest, flexible and have a commitment to resolve conflicts

16.

Emotional intelligence?

A different type of intelligence, composed of: perceiving emotions, using and reasoning with emotions, understanding emotions, and managing emotions. ● The possession of social skills, interpersonal competence, psychological maturity, and emotional awareness devoted to helping people work well together is known as emotional intelligence. ● Emotional intelligence is what helps people see others in a positive light. In other words, two managers could reach the same decision and present the idea to two groups. The one with the skills inherent in emotional intelligence is likely to be perceived in more positive terms, even though the outcome may be the same.

17.

To be considered emotionally intelligent, strive for these five traits:

○ Have self-awareness: You can identify the emotions you are feeling and you know how they may be altering your perceptions. ○ Manage emotions: Your negative emotions -anger, fear, and passive-aggressiveness, can be avoided. ○ Motivate yourself: You are inwardly rather than externally driven. ○ Be empathetic: You value differences in viewpoints and don't side with one group versus another. ○ Handle relationships: You are socially appropriate. ● Emotional intelligence is the ability of an individual to perceive and manage the emotions of self and others. Nurses must be able to perceive and understand their own emotions and the emotions of their clients and families in order to provide real client-centered care. ● Emotional intelligence is also an important characteristic of the successful nurse leader, as this leader will have insight into the emotions of members of the team. He or she understands the perspective of others and will encourage constructive criticism and be open to new ideas. The emotionally intelligent leader is able to maintain focus while multitasking. He or she will manage emotions and channel them into a positive direction, which in turn helps the team accomplish its goals. ● The emotionally intelligent leader is committed to the delivery of high-quality client care and refrains from judgment in controversial or emotionally charged situations until facts are gathered. ● Emotional intelligence is developed through understanding the concept and applying it to practice in everyday situations.

18.

Know the phases of prevention:

Primary Efforts to prevent an injury or illness from ever occurring. Education to avoid occurrence of disease; stop smoking, nutrition, immunization, exercise Secondary Focuses on early identification of individuals or communities experiencing early disease process to initiate treatment Ultrasounds, vision screening, blood pressure screening Tertiary Minimize the effects of the disease through treatment modalities Manage gestational diabetes, nutrition counseling for someone with HTN

19.

What is Health Promotion?

For our purpose, know that the World Health Organization's (WHO) definition is that health promotion is the process of enabling people to increase control over, and to improve, their health. Be aware, though, that the concept of health differs between people. What is meant by health? The WHO defines health as "a state of complete physical, mental, and social well-being and not merely the absence of disease and infirmity". Wellness is another term often used for health, but there is no WHO definition for it. Health can be the absence of disease, while wellness implies a positive state of health in mental, spiritual, environmental aspects. Disease, then, may be defined as a disturbance in a person's health status. Illness, too, has physical attributes but both disease and illness may be highly related to the experience of the individual. Many individuals can experience "wellness" in the presence of an illness. One example might be a person who has a chronic illness such as asthma and can, with medication management, still ride a bike, go for walks, etc. Health and wellness can be present in the face of illness.

20.

How does culture impact the patient's understanding of the nurses' teachings?

Take culture into account; differences and preferences. Optimal health is individualized. ● Nursing is a multifaceted process that includes a range of activities such as the promotion and maintenance of health through education, the restoration of health through care of the sick and injured, and preparation for death through care of the dying. Cultural competence is important to facilitate the use of culturally appropriate interventions, based on the values and beliefs of the targeted group. Nurses must be committed to developing skills in cultural competence.

21.

What about the use of Alternative medical/herbal therapies?

Outside the realm of traditional western way of healing and treatment. Seek providers that practice concepts of holism "treat whole person" rather than just physical symptoms of the disease Clients belief in the effectiveness is just as important as treatment Energy healing: the client views energy systems as fields, vital essences, balances, and flow which may be used to prevent illness, promote health, and heal themselves. Examples of energy medicine include biofeedback, magnet therapy, and sound or light therapy. Nutritional therapy: Nutrition definitely plays a large part in a state of wellbeing. Some clients will focus on eliminating "bad" foods and/or adding "good" foods and supplements in an attempt to regulate health. These clients may drastically change their diets and cause imbalances of necessary nutrients. Careful attention must be given to patients taking supplements, herbal remedies, and severe diets. Herbal remedies: Herbalism, or "botanical medicine," is the study and use of herbs or crude-based plant products for medicinal purposes. Plants can also be used to treat illness and improve the spiritual and physical quality of life. Western medicine also uses plant based therapy i...