Primary purpose for the development of the Quality and Safety Education for Nurses
Quality Safety and Education for Nurses (QSEN) initiative aim to
... [Show More] recast nursing education towards an ambitious new goal to prepare new nurses to not only provide excellent health care to families and individuals, but again provide constant improvement in safety and quality of the health care systems in which they work.
Robert Wood Johnson Foundation Recommendation
80% of all RN's hold a Bachelor's degree by 2020
IOM Recommendations for 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 health care professionals, in redesigning health care in the United States.
How Technology has Improved Healthcare
The use of computers has made it easy to make claims and ensure that insurance companies make reimbursements and hence improving the financial status of the health facilities.
Ease of access to EHR
Ease of access to research for EBP
Identify what a new graduate nurse who is having unresolved role conflicts may experience.
New nurses experience high level of anxiety in case of unresolved conflicts. Conflict produces frustrations and increases anxiety which again rises the perception of conflict by producing a feeling of helplessness.
QSEN Compentencies
Patient-Centered Care
Teamwork and Collaboration
Evidence-Based Practice
Quality Improvement
Safety
Informatics
Laws
Rules of behavior established by a political authority and backed by state power.
What do nurses need to do to become more recognized as a profession?
Be fully committed to the profession of nursing
ID it as a profession and dedicate to future development
Not considered a life long career
How does increased responsibility impact nurses' need for further education?
High intellect and level of responsibility & accountability; specialized body of knowledge which is learned in higher education.
What did Florence Nightingale bring to the profession?
To prepare high quality nurses; formal systematic education in theory and practice is essential.
ANA
Concerned with quality of nursing practice in daily healthcare setting.
Baccalaureate education should be the basic level of
preparation for professional nurse.
How can nurse managers build better teams?
Engaged decision making; invite the ideas of the team (transformational leadership)
Allow to express feelings
High interaction among team members to increase trust and openness
Authoritative Leader
Makes decisions for the group.
Good in code situations
Democratic Leader
These leaders include the group when decisions are made. They tend to motivate by supporting achievements made by group members and they communicate both up and down the chain of command. Their staff's work output is usually good because cooperation is valued.
Laissez-Faire Leader
Makes few decisions, the group makes decisions for itself.
This style may be effective with professional employees who have personal integrity and accountability.
Transformational Leader
Empowers followers to assume responsibility for a shared vision.
Personal development is a secondary outcome.
Transactional Leader
Focus on immediate problems, maintaining the status quo and using rewards to motivate followers.
Assertive Communication
Allows expression in direct, honest, and nonthreatening ways do not infringe upon the rights of others
It accurately expresses a person's feelings, beliefs, ideas, and opinion
Conflictual Communication
Resolve conflicts productively depends on addressing thoughts, feelings, and behaviors that form barriers to resolution.
Stages of Conflict
Frustration, conceptualization, action, and outcomes
Aggressive Communication
Used to humiliate, control, or embarrass the other person or lower self-esteem.
Leading vs. Managing
Management, on the other hand, is the process of "guiding others through a set of derived practices and procedures."
Leadership, according to Yoder-Wise (2011), is "engaged decision making" connected to the actions used in clinical situations "for which no standardized solution exists"
Which is a Joint Commission on Accreditation of Healthcare Organizations (JCAHO) requirement for client education?
The Joint Commission requires documentation of patient teaching in the charts and makes "surprise" visits to facilities to ensure the teaching plans are being carried out.
What can a nurse manager do about conflict in the team?
Collaboration of conflicting team members to work out solution to conflict.
Follow chain of command
What motivates clients to learn?
Develop objectives with the client and family.
Stress and pain are factors that will obscure a client's ability to learn.
Client has a high educational level.
What may cause some people to make responses that seem inappropriate or overemotional?
Lack of an opportunity to develop coping skills at workplace can cause some people to make responses that seem overemotional or inappropriate. Dealing with emotions at workplace is unavoidable, and the way we deal with them may at large determine our behavior. Employees take their normal humanity to work daily, and while at workplace it is impossible to avoid emotions all the time.
What is an important role that the nursing process fulfills in professional nursing?
The responsibility of nurses is to provide their patients with high-quality care. Nurses should be familiar with ethical codes of contact in their field of practice and the essentials of ethical decision making.
Identify the most appropriate political activities for nurses at the state level.
Nurse participation in political activities has remained low even after many professional nursing organizations, scholars in the nursing field, and other health focused organizations encouraging and expecting nurses to engage in socio-political activities. Participation of nurses in this field can give them an opportunity to compete for the scarce resources that are available, suggest legislations and seek sponsors to promote their department and the health sector at large.
A client asks what the Affordable Care Act is. The nurse's best response is:
A) "The law is only for those on Medicare Part D."
B) "The law requires that most of the assets be absorbed."
C) "The law has been written for those seniors who are under Medicaid."
D) "The law has been written for seniors and those of all ages for a positive outcome."
D) "The law has been written for seniors and those of all ages for a positive outcome."
Identify which of the following statements is most accurate about the vast majority of the elderly.
A) They all have chronic diseases and are in assisted-care facilities.
B) They make up the single largest expenditure for the federal government budget.
C) They are relatively healthy and most manage their chronic conditions at home.
D) They have high levels of depression and are usually in bad spirits.
C) They are relatively healthy and most manage their chronic conditions at home.
What is a major benefit for the elderly who now have easy access to and use of technology such as the Internet and smartphones?
A) They have opportunities to obtain screening and treatment that they might not otherwise seek.
B) They can reach hospitals and family if they need help.
C) They generally are so confused by the technology, they abandon it.
D) They now have a new source of entertainment to keep their minds active and delay the effects of dementia.
A) They have opportunities to obtain screening and treatment that they might not otherwise seek.
What is the best way to increase the motivation to learn in the elderly population?
A) Use negative reinforcements when an elderly person does not change behavior appropriately
B) Ignore their life experiences so that the learning is not contaminated by misinformation from the past.
C) Use the power disparity between the teacher and the client to reinforce basic principles.
D) Link positive reinforcement to changes in behavior.
D) Link positive reinforcement to changes in behavior
Select the factor that is most likely to increase a client's motivation to learn.
A) A severe illness with the potential to be fatal
B) The presence of the client's significant other during teaching session
C) A college education
D) A high socioeconomic level
C) A college education
Chief causes of Burnout?
A prolonged response to chronic emotional and interpersonal stressors on the job
Perception of stressors, how they are mediated, and level of adaptation by the individual are important.
Characteristics of Burnout?
Physical exhaustion
Mental exhaustion
Emotional exhaustion
Cynicism
Somatization
Depersonalization
Preventing Burnout?
Find the right workplace.
Identify daily stressors.
Change the perception of the stressor.
Insist on equipment that prevents physical stress.
Population at Burnout
Are more intelligent than average, hard-working, idealistic, and a perfectionistic.
What is discharge teaching?
Starts at admission
How to care for themselves at home
Healthcare team must look ahead with the clients needs in mind
Effects on the profession as well as on individual nurses?
Many nurses who are burning out block the signs because they put so much time, money, and energy into preparing for a career they no longer want to have.
Burnout may be contributors to the spread of infection, increases in client clinical errors, such as medication mistakes, missing treatments, and missing signs and symptoms of serious changes in condition, and error in documenting
Why is there a nursing shortage?
The U.S. is projected to experience a shortage of Registered Nurses (RNs) that is expected to intensify as Baby Boomers age and the need for health care grows. Compounding the problem is the fact that nursing schools across the country are struggling to expand capacity to meet the rising demand for care given the national move toward healthcare reform. The American Association of Colleges of Nursing (AACN) is working with schools, policy makers, nursing organizations, and the media to bring attention to this healthcare concern.
How does the nurse advocate for the client?
...
What are appropriate political activities for nurses? Why does it matter?
State legislator; they don't have healthcare background
Because politics and health care laws are related to every aspect of life: Where and when our children go to school, quality of food and water, medications, prescriptions, over the counter drugs, where nurses work, professional status through licensure and certification.
How do nurses ensure the teaching has been effective?
Teach patient at level and language they understand
Take time to teach (not rushed)
Patient can demonstrate or "teach back" teachings
Nursing Process: Review the steps and understand the significance.
The five steps of the nursing process are:
-Assessment
-Diagnosis
-Planning,
-Implementation
-Evaluation
Autonomy
Right to choose for oneself; personal freedom
Fidelity
Keeping ones promises/commitments
Non-Maleficene
One should do no harm
Justice
Persons treated equally/fairly
Beneficence
Doing good and promoting good for the patient
Veracity
Duty to tell the truth
What is accountability?
Expectation of explaining actions and results.
Understand nurses' need to be accountable in all situations.
Know the first steps in the process to arrive at a positive outcome.
Blending of characteristics, theoretical and experiential knowledge, interpersonal skills, and technical skills.
Critical thinking?
Very first step: IDENTIFY THE PROBLEM
-Interpretation (understand info)
-Analysis (piece together)
-Inference (draw conclusions)
-Evaluation (credibility)
-Explaination (clarity & restate info)
-Self-Regulation (aware of own thinking abilities)
How is clinical judgment gained?
Clinical Judgment is gained by tactic knowledge and experience in clinical setting
How does the nurse prioritize care?
ABC's
Maslow's Hierarchy
Urgent/Stable
Chronic/New
How does the nurse delegate care and to whom?
E-A-T [do not delegate what nurse can: Evaluate, Assess, Teach]
Is transferring the authority or responsibility to perform selected tasks in a selected situation to a competent individual
Nurse is responsible for task delegated
Complementary and Alternative Medicine (CAM): Why is the term healing used rather than medicine when referring to alternative care?
Because "medicine" patients associate with hospitals and doctors and "healing" with alternative care???
Complementary Medicine Examples
Western Medicine
Vaccinations
Pharmaceuticals
Alternative Medicine Examples
Eastern Medicine
Herbs
Accupuncture
Healing Crystals
Energy Healing
How can nurses advocate for their patients?
Supports client in ensuring that they are properly informed, rights are respected, and receiving proper level of care.
Act as advocates even when disagree with clients decision
Act as advocate when health care system is not acting in their best interests
Dietary Supplments
Although the FDA requires dietary supplements to include percent of daily value, it doesn't validate accuracy. As a result, some manufacturers of dietary supplements will add substances that have no daily value but will increase the cost. Also, some manufacturers will add large amounts of cheap nutrients but small amounts of expensive ones.
NOT REGULATED
Nursing Competency Concerning CAM
Nurses must be educated about the pro and cons of complementary/alternative therapies and be prepared to discuss and help resolve ethical issues surrounding them. (ANA Website)
After assessing an older adult client in long-term care who has been slowly deteriorating for weeks, the nurse manager calls the family and asks them to come in, as the client is dying. What are the nurse manager's decision and actions based on?
The nurse manager's decision and actions were based on tacit knowledge and clinical judgement of the patient. Having cared for the patient for a long period of time with close monitoring of any physical, emotional, and psychological changes, the nurse is able to know that the slowly deteriorating patient is about to die.
Identify the most important element in nursing's attempt to gain full autonomy of practice.
A)Economic exploitation of nurses
B)Maintaining the education system for nurses as it is now
C)Gaining and maintaining control of nursing practice by nurses
D)Restricting the latitude of decisions made by nurses
C) Gaining and maintaining control of nursing practice by nurses
Which step of the nursing process identifies the success or failure of the plan of care developed by a nurse?
The evaluation process seeks to identify the strengths and the weaknesses of the whole process. The aim is to identify the areas of improvement in future in an attempt to make healthcare service better than ever before.
What is a recommended method for nurses to prepare for future professional practice?
Understand and explore issues involved in professionalism as nurses.
Which activity tends to increase nurses' satisfaction during work?
a. multitasking to complete all assigned work
b. taking time to talk with clients about their needs
c. doing all important tasks themselves to make sure they are done correctly
d. putting off difficult activities until the end of the shift
b. taking time to talk with clients about their needs
Identify the primary purpose for the development of the QSEN project.
a. increase the number of students in nursing programs
b. shift nursing education to a more medical model due to the increased client acuity
c. focus nursing education on competencies to reduce the number of medical errors
d. decrease the number of associate degree nursing programs
c. focus nursing education on competencies to reduce the number of medical errors
What is the primary reason a nurse should develop learning objectives for all client teaching?
a. the nurse can clarify with the client what actions or behaviors are expected
b. it is a requirement by the joint commission on accreditation of healthcare organizations
c. Learning objectives help the nurse to organize the teaching materials.
d. clients who do not have learning objectives will learn material poorly
c. Learning objectives help the nurse to organize the teaching materials.
Identify the health care area in which the use of computers has improved the efficiency of care.
a. documentation
b. interdepartmental communication
c. administration
d. physician record keeping
a. documentation
Which contribution of Florence Nightingale had the greatest impact on nursing education?
a. recognizing that formal, systematic education in both theory and practice was essential for the preparation of high quality nurses.
b. advocating that all nurses be educated in universities so that nursing care would meet the standards established by the government
c. forcing physicians and hospitals to recognize that clinical practice was not as important as the theory based learning obtained in the classroom
d. enforcing the requirement that all nursing instructors
a. recognizing that formal, systematic education in both theory and practice was essential for the preparation of high quality nurses.
Identify the primary position advocated by the 1965 ANA position paper on education for nurses?
a. any nursing education program is acceptable as long as the graduates take and pass the NCLEX examination
b. baccalaureate education should be the basic level of preparation for professional nurses
c. associate degree education should be the basic level of preparation for professional nurses
d. only nurses educated at the master degree or higher level should be considered professional nurses
b. baccalaureate education should be the basic level of preparation for professional nurses
Why is the input of nurses vital to legislators?
a. most of the bills legislators pass are not related to health care
b. voters can be easily misled by special interest groups
c. the majority of legislators do not have health care backgrounds
d. legislators need to be aware of the important part nurses play in health care
c. the majority of legislators do not have health care backgrounds
Identify the outcome that best demonstrates a critical care nurse's successful application of the ethical principle of veracity to the care of a client who was diagnosed with late stage pancreatic cancer.
a. the client is aware of his or her diagnosis despite attempts of the family to withhold that information
b. the client is beginning to be able to use simple words to express his or her needs
c. the family has been taught the necessary skills to care for the client at home with the supervision of a home health care nurse.
d. there is no evidence of skin breakdown on bony pressure points, and the client's shoulder and hip on the affected side remain intact.
a. the client is aware of his or her diagnosis despite attempts of the family to withhold that information
Provision number 7 of the 2001 code of ethics for nurses states: "the nurse participates in the advancement of the profession through contributions to practice, education, administration and knowledge development." On which ethical principle is this statement primarily based?
a. veracity
b. autonomy
c. accountability
d. beneficence
c. accountability [Show Less]