assessment
nurse collects comprehensive data to pertinent to the patient's health and/or the situation
diagnosis
nurse analyzes the assessment
... [Show More] data to determine the diagnoses or issues
accountability
responsible professionally and legally for the type and quality of nursing provided, ability to answer for one's own actions
caregiver
Helps patients maintain and regain health, manage disease and symptoms, and attain a maximal level of function and independence through the healing process
patient advocate
you protect your patient's human and legal rights and provide assistance in asserting these rights if the need arises
educator
you explain concepts and facts about health, describe the reason for routine care activities, demonstrate procedures such as self-care activities, reinforce learning or patient behavior, and evaluate the patient's progress in learning
communicator
essential to the nurse-patient relationship; it allows you to know your patients including their strengths, weaknesses, and needs
manager
Coordinates the activities of members of the nursing staff in delivering nursing care and has personnel, policy, and budgetary responsibility for a specific nursing unit or agency
Florence Nightingale
Established sanitary nursing care units. Founder of modern nursing. began professional education of nursing.
Clara Barton
Nurse during the Civil War; founder of the American Red Cross
Mother Bickerdyke
organized ambulance services and walked abandoned battlefields at night, looking for wounded soldiers.
Mary Mahoney
First professionally trained African American nurse; brought cultural diversity and respect
Lillian Wald and Mary Brewster
Opened the Henry Street Settlement, focusing on the health needs of the poor
Mary Nutting
First Nursing professor at Columbia Teachers College.
Helped move nursing into universities.
health
A state of complete physical, mental, and social well-being, not merely the absence of disease or infirmity
health beliefs
person's ideas, convictions, and attitudes about health and illness. They may be based on factual information or misinformation, common sense or myths, or reality or false expectations
positive health behaviors
activities related to maintaining, attaining, or regaining good health and preventing illness
negative health behaviors
include practices actually or potentially harmful to health
health promotion model focuses on which 3 areas
(1) individual characteristics and experiences
(2) behavior-specific knowledge and effect
(3) behavioral outcomes, in which the patient commits to or changes a behavior
health promoting behavior
the desired behavioral outcome and the end point in the HPM. Health-promoting behaviors result in improved health, enhanced functional ability, and better quality of life at all stages of development
health promotion model (HPM)
-defines health as a positive, dynamic state, not merely the absence of disease
-directed at increasing a patient's level of well-being
Maslow's hierarchy of needs
-model that nurses use to understand the interrelationships of basic human needs
-basic human need are elements that are necessary for human survival and health
internal variables
a person's developmental stage, intellectual background, perception of functioning, and emotional and spiritual factors
external variables
a person's health beliefs and practices include family practices, socioeconomic factors, and cultural background
Nursing incorporates health promotion activities, wellness education, and illness prevention activities rather than simply treating illness in three ways:
-immunization programs
-routine exercise and good nutrition
-physical awareness, stress management, and self responsibility
primary prevention
True prevention that lowers the chances that a disease will develop
secondary prevention
Focuses on those who have health problems or illnesses and are at risk for developing complications or worsening conditions
tertiary prevention
Occurs when a defect or disability is permanent or irreversible
risk factors
characteristics or behaviors that increase the likelihood of developing a medical disorder or disease
examples:
-Genetic and physiological factors
-age
-environment
-lifestyle
Precontemplation stage
no intention of changing behavior
Contemplation stage
considering a change within the next 6 months
Preparation stage
making small changes
Action stage
actively engaging in strategies to change behavior
Maintenance stage
maintaining a changed behavior
illness
A state in which a person's physical, emotional, intellectual, social, developmental, or spiritual functioning is diminished or impaired
acute illness
reversible, has a short duration, and is often severe. The symptoms appear abruptly, are intense, and often subside after a relatively short period
chronic illness
persists, usually longer than 6 months, is irreversible, and affects functioning in one or more systems. Patients often fluctuate between maximal functioning and serious health relapses that may be life threatening
illness behavior
Involves how people monitor their bodies and define and interpret their symptoms
Impact of Illness on the Patient and Family
-Behavioral and emotional changes
-Impact on body image
-Impact on self-concept
-Impact on family roles
-Impact on family dynamics
challenges to health care
-Uninsured patients
-Reducing health care costs while maintaining high-quality care for patients
-Improving access and coverage for more people
-Encouraging healthy behaviors
-Earlier hospital discharges result in more patients needing nursing homes or home care
national priorities partnership
-Promote best practices, prevention, treatment, communication, care coordination, and intervention practices for the leading causes of mortality
-Ensure person and family centered care
-Make care safer and quality care affordable
the institute of medicine guides nurses to transform by
training, achieve higher levels of education, build partnerships with physicians, and improve information infrastructure
Professional standards review organizations (PSROs)
Created to review the quality, quantity, and cost of hospital care provided through Medicare and Medicaid
Utilization review (UR) committees
Review admissions, diagnostic testing, and treatments ordered by physicians who cared for patients receiving Medicare
Patient Protection and Affordable Care Act
passed in 2010, focuses on the major goals of increasing access to health care services for all, reducing health care costs, and improving health care quality.
health services pyramid
population based health care services, clinical preventative services, primary health care, secondary health care, tertiary health care
6 health care settings and services
preventative, primary, secondary, tertiary, restorative, continuing
prevenative care
Reduces and controls risk factors for disease
primary care
-Focuses on improved health outcomes
-Requires collaboration
secondary and tertiary care
Diagnosis and treatment of disease provided by Hospital emergency departments, urgent care centers, critical care units, and inpatient medical-surgical units
restorative care
-Serves patients recovering from an acute or chronic illness/disability
-Helps individuals regain maximal function and enhance quality of life
-consists of: home health care, rehabilitation, extended care
continuing care
-For people who are disabled, functionally dependent, or suffering a terminal disease
-Available within institutional settings or in the home for example: Nursing centers or facilities, Assisted living, Respite care, Adult day care centers, Hospice
Nursing Centers or Facilities
-provide 24hr intermediate and custodial care
-regulated by Omnibus Budget Reconciliation Act
-clinical practice must complete MDS and RAIs
assisted living
Long-term care setting
Home environment
Greater resident autonomy
No fee caps
respite care
Respite care provides short-term relief or "time off" for people providing home care to an individual who is ill, disabled, or frail.
adult day care centers
Provide a variety of health and social services to specific patient populations who live alone or with family in the community
hospice
-Family centered care that allows patients to live with comfort, independence, and dignity while easing the pains of terminal illness
-focuses on palliative (non-curable) care
Accountable care organizations (ACOs)
Developed to coordinate medical care, strives to ensure that patients receive the right care at the right time, without duplication of services or incidence of medical errors
Patient-centered medical home (PCMH)
uses technology, teamwork, and effective communication with patients to make care culturally sensitive and accessible, gather clinical data, promote patient participation in decision making, and monitor patient outcomes
issues in health care delivery
- Nursing shortage
- Competency
- Quality and safety in health care (Pay for performance, Patient satisfaction)
- Magnet Recognition Program (Nursing-sensitive outcomes)
- Nursing informatics & technological advancements
- Globalization of Health Care (Vulnerable Populations)
Quality improvement (QI)
an approach to the continuous study and improvement of the processes of providing health care services to meet the needs of patients and others and inform health care policy
Performance Improvement (PI)
an organization analyzes and evaluates current performance and uses the results to develop focused improvement actions
federal government pays for ______________ and created professional standards review organizations (PSROs)
medicare/medicaid
professional standards review organizations (PSROs)
review the quality, quantity, and cost of hospital care
Utilization Review (UR) Committees
review the admissions and identify and eliminate overuse of diagnostic and treatment services ordered by physicians caring for patients on Medicare
Prospective Payment System (PPS)
Eliminated cost-based reimbursement and grouped patients into diagnosis-related groups (DRGs)
diagnosis-related groups (DRGs)
each group has a fixed reimbursement amount with adjustments based on case severity, rural/urban/regional costs, and teaching costs
capitation
providers receive a fixed amount per patient or enrollee of a health care plan
managed care
providers receive predetermined capitalized payment for each patient enrolled
Managed Care Organization (MCO)
preventative measures and treatment to specific groups
Preffered Provider Organization (PPO)
A managed care organization of doctors, hospitals, and other providers who have an agreement with an insurer to provide health care at reduced rates to subscribers. PPO clients do not pay deductibles when using the preferred providers, but can use other providers and pay a higher co-payment as well as a deductible.
medicare part A
Inpatient coverage, home health, hospice
medicare part B
physician services, outpatient hospital services, durable medical equipment, and other services and supplies covered
medicare part C
Medicare Advantage
medicare part D
Prescription drug coverage
who is covered under medicaid
assisted care to low income patients
long term care insurance
-Insurance covered for patients under long term care
-set cost for unlimited time (2yr minimum)
State Children's Health Insurance Program (SCHIP)
a public health insurance program, jointly funded by the federal and state governments, that provides health insurance coverage for children whose families meet income eligibility standards
Health Services Pyramid
1. population based health care services
2. clinical preventive services
3. primary health care
4. secondary health care
5. tertiary health care [Show Less]