NUR2058 Final Exam Concept Guide-2

NUR2058 Final Exam Concept Guide-2 1. Methods to Measure and Improve Quality (Chapter 15) - Quality assurance (QA) in health care attempts to guarantee that when an action is performed by a health-care professional, it is performed correctly the first time and each time thereafter. QA requires that actions and activities are continuously measured and compared to a standard of care established by a professional organization and that process of monitoring be in place to provide continuous feedback to prevent errors. Quality control is focused on health-care outcomes. 2. Approaches in Resolving Conflict (Chapter 13) - No change. Keep in mind that it is highly unlikely that a difficult person will change his or her behavior very much, particularly if that person is a coworker. However, one of our goals in teaching and caring for clients is to change behavior even if they are displaying difficult behaviors. The key to remember here is that we need to change our own perceptions and the way we approach a difficult person.2 Difficult people tend to make us anxious, frustrated, and angry, but we cannot show them these feelings. 2. No reinforcement. It is a basic tenant in psychology that reinforcing a behavior will cause the behavior to be repeated (e.g., Pavlov's dogs). It is interesting that the reinforcement can be either positive or negative. Providing punishment for something someone is doing is often the payoff the difficult person is looking for, and he or she will repeat the behavior to get additional payoffs. The most powerful reinforcement is intermittent reward or punishment. This is where the behavior is rewarded or punished one time and then ignored the next. It keeps the behavior going because the person is wondering when the next reinforcement will come. 3. No action. There is an old saying that “doing nothing is doing something!” This means that when dealing with difficult people, if we do nothing, we are in reality reinforcing their behavior. 4. No anonymity. Identify the particular behaviors they are displaying as difficult and call the behaviors by name. “Letting it go” actually reinforces the behavior (see #3). 5. No ashes. Another old saying is “Fight fire with fire”; however, the result of this approach is scorched earth and ashes. Again, this may be the outcome that the difficult person is seeking. He or she wins when nothing is left but ashes! 6. No condemnation. The difficult person had probably developed this type of behavior over a long period of time and is doing the best they can. Although it may not seem so, they usually are not malicious or hateful, and condemning them as such really misses the point.3 Difficult people lack the basic communication skills to interact successfully with others and are constantly seeking to fulfill a need or achieve an outcome by their behavior. 7. No robbery. You must believe that you are 100 percent responsible for your own happiness, because you are. Happiness comes from within yourself, and it is not up to others to make you happy. Similarly, it is up to us to control our unhappiness. Sometimes it is the goal of some difficult people to rob us of our happiness because they are unhappy (misery loves company). Don't let them do it! Find happy people to hang out with! Find some fulfilling activity outside of the work setting. 3. QSEN Competency Guide for Nursing Curriculum (Chapter 4) - Quality and Safety Education for Nurses developed by IOM for nursing students 5 Competencies: Client-centered care, teamwork and collaboration, Evidence-based practice (EBP), Quality improvement (QI), safety, and informatics. Competencies help guide what is being taught in nursing curricula. Rapid health-care technology advances have put a strain on both the faculty teaching nursing students and students attempting to master it. Competencies are built on the five competencies developed initially by the Institute of Medicine (IOM). 4. What is Quality of Care? (Chapter 15) - Like most complex concepts, there are several different definitions of quality care. The Institute of Medicine (IOM) defines quality as “the degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge.”1 Its three accepted elements are structure, process, and outcome, while care should be safe, effective, client-centered, timely, efficient, and equitable. 5. 98,000 Deaths per Year (Chapter 15) - When the Institute of Medicine (IOM) published its first report in 2000, To Err Is Human: Building a Safer Health System, it estimated that 98,000 people die per year due to adverse events and medical errors in hospitals.3 The report focused on faulty systems, processes, and conditions that led to mistakes. It recommended system changes for advocated strategies to reduce the number of errors and improve the quality of health care. The report recommended a four-tiered approach: 1. Establish leadership, research, tools, and protocols to enhance the safety knowledge base. 2. Develop a public mandatory national reporting system and encourage participation in voluntary reporting systems. 3. Use oversight organizations, health-care purchasers, and professional organizations to increase performance standards and expectations for safety improvements. 4. Implement safety systems at the point of care delivery in health-care organizations. 6. Establishing Standards (Chapter 2) - World War II produced another nursing shortage, and in response, Congress passed the Bolton Act, which shortened hospital-based training programs from 36 to 30 months. The new Cadet Nurse Corps established minimum educational standards for nursing programs and forbade discrimination on the basis of race, creed, or sex.2 Many schools revised and improved their curricula to meet these new standards. To encourage more nurses to enter the military, the U.S. government granted women full commissioned status and gave them the same pay as men with the same rank. By the end of the war, African American and male nurses were also admitted to the armed services. 7. Florence Nightingale (Chapter 2) - (1820–1910) Universally regarded as the founder of modern nursing, Florence Nightingale dedicated her long life to improving health care and nursing standards. Raised in England, Nightingale was considered highly educated for her time. Through travels with her family, she became aware of the substandard health care in many countries in Europe. In 1851, she attended a 3-month nurses’ training program at the church-run hospital in Kaiserswerth, Germany. She was impressed with the program but believed this brief training was insufficient. She later ran a private nursing home and realized that the only way to improve health care was to educate women to be reliable, high-quality nurses. Plans to develop a school of nursing in England were interrupted in 1854 by a cholera epidemic. Nightingale volunteered her services and learned a great deal about how to prevent the spread of disease. When the Crimean War broke out that same year, she obtained permission to take a group of 37 volunteer nurses into the battlefield area. British medical officers initially refused their assistance, but as conditions worsened, the nurses were admitted to the hospital. 8. Conclusion (Nursing Theory) (Chapter 3) - As nursing takes its rightful place among the other helping professions, nursing theory will take on additional importance. Nursing theories and models are the systematic conceptualizations of nursing practice and how they fit into the health-care system. Nursing theories help describe, explain, predict, and control nursing activities to achieve the goals of client care. By understanding and using nursing theory, nurses will be better able to incorporate theoretical information into their practice to provide new ways of approaching nursing care and improving nursing practice. The development of nursing theory and models indicates a maturing of the profession. As the knowledge associated with the profession increases and becomes unique, more complex, and better organized, the general body of nursing science knowledge also increases and EBP becomes a reality. When nursing becomes a well-developed body of specialized knowledge, it will be fully recognized as a separate scientific discipline and take its rightful place as a true profession. 9. Follow up Case Management (Chapter 4) - Currently, in many licensed practical nurse and licensed vocational nurse (LPN/LVN) programs and schools offering the associate degree in nursing, clinical experiences consist of one-time, 8-hour provision of care for an acute or chronically ill client. Little time is spent in follow-up care. However, many bachelor of science in nursing (BSN) programs and some associate degree nursing (ADN) programs have expanded clinical experiences to include discharge planning and follow-up home health-care experiences. “Case management includes overseeing the clients’ care while they are in the hospital and following clients through their rehabilitation at home, long-term follow-up, health-care practices, and developmental stages.” To meet the demands of the future health-care system, all nursing education programs must be able to develop learning experiences for students that involve care for selected individuals or families over extended periods of time, perhaps ranging from several weeks to several semesters. 10. The Nurses Involvement; Criminal vs. Civil Law (Chapter 8) - Criminal laws are concerned with providing protection for all members of society. When someone is accused of violating a criminal law, the government at the county, city, state, or federal level imposes a punishment that is appropriate to the type of crime. Criminal law involves a wide range of malfeasance, from minor traffic violations to murder. Although most criminal law is created and regulated by the government through the enactment of statutes, a small portion falls under the common law. Statutes are developed and enacted by the legislature (state or federal) and approved by the executive branch, such as a governor or the president. Criminal law is further classified into two types of offenses: (1) misdemeanors, which are minor criminal offenses, and (2) felonies, which are major criminal offenses. - Nurses are much more likely to become involved in civil lawsuits than in criminal violations. Civil laws generally deal with the violation of one individual's rights by another individual. The court provides the forum that enables these individuals to have their disputes resolved by an independent third party, such as a judge or a jury of the defendant's peers. The individual who brings the dispute to the court is called the plaintiff. The formal written document that describes the dispute and the resolution sought is called the complaint. The individual against whom the complaint is filed is the defendant, who, in conjunction with his or her attorney, prepares the answer to the complaint. In civil cases, the burden of proof rests with the plaintiff. .....