Virtual ATI Comprehensive Predictor

1. Delegation for effective task management. A nurse is re- sponsible for pro- viding clear direc- tions when a task is initially delegat- ed and for periodic reassessment and evaluation of the outcome of the task. RNs must dele- gate tasks so that they can complete higher level tasks. RNs may delegate to other RNs, PNs or APs. PNs may delegate to other PNs or APs. Predictability of outcome: Is this routine, or is this new, is there po- tential for compli- cations Potential for harm: Is the client sta- ble? Risks? Aspi- ration, Bleeding Complexity of Care: Does the delegatee have the license to per- form the task, and the training? Need for problem solving: Does this require the nurs- ing process? As- sessment skills or judgment Level of client in- teraction: Is there psychosocial sup- port needed? 2. TO PN Monitoring find- ings Reinforcing client teaching Tracheostomy Care Suctioning NG tube patency Enteral Feedings Insert Catheter Administering Meds 3. TO AP ADLs Bathing, Grooming, Dress- ing, Toliet Ambulating Feeding Positioning Routine tasks Bed making Specimen Collec- tion, I and Os Vitals For stable clients 4. Concepts of management—Strategies to identify so- lutions to community health problems Planning Organizing: Controlling: Directing: Staffing: 5. Planning: What needs to be done, and who is going to do it 6. Organizing: Lines of au- thority, commu- nications, and where decisions are made 7. Directing: Influences and motivates people to perform 8. Controlling: The evaluation of performance and unit goals to en- sure outcomes are met 9. Staffing: Adequate staffing, and staffing mix 10. Characteristics of managers: Hold formal po- sitions of au- thority and pow- er, Possess clini- cal expertise, Net- work with mem- bers of the team, Coach subordi- nates, Make de- cisions for the organization: Re- 11. Conflict Management between health care workers sources, Budget, Hiring, and Firing 12. Autonomy: The ability of the client to make per- sonal decisions, even when those decisions might not be in the client's own best interest 13. Beneficence: Care that is in the best interest of the client 14. Fidelity: Keeping one's promise to the client about care that was offered 15. Justice: Fair treatment in matters related to physical and psychosocial care and use of re- sources 16. Nonmaleficence: The nurse's oblig- ation to avoid causing harm to the client 17. Veracity: The nurse's duty to tell the truth 18. Examples when an incident report should be filed: Medication er- rors, Proce- 19. Establishing Priorities---Facility Protocols: Triage evaluation of peds dure/treatment er- rors, Equipment related injuries/er- rors, Needlestick injuries, Client falls, Visitor/Vol- unteer injuries, Threat made to client or staff, Loss of property. Emergent: Urgent Nonurgent: Expectant: 20. Emergent: Highest priority, life threatening in- juries but also have high survival rate once stable 21. Urgent: Second highest priority can wait 40-60 mins for treatment 22. Nonurgent: Minor injuries that are not life threat- ening and do not need immediate attention 23. Expectant: Lowest priority, ex- pected to die, Comfort care, but not restorative care 24. Determining Priority Care for a group of clients 25. Prioritizing Care for multiple home care clients Life before limb Acute before Chronic Actual problems before potential problems Listen carefully to clients and don't assume Trends vs Tran- sient findings Complications vs expected findings 26. Prioritizing Care for post op clients Airway, Breathing, Circulation, Dis- ability, Examina- tion/Exposure 27. Maslow's Hierarchy Physiological, Safety and Security, Love and Belonging, Self-esteem, Self-Actualization 28. Speaking to a client who has a hearing Impairment Learn the clients' preferred method of communica- tions and make accommodations. Avoid covering your mouth Sit and face the client Speak slowly and clearly Encourage the use of hearing de- vices Try lowering vo- cal pitch before in- creasing volume Do not shout Use brief sen- tences with simple words Minimize back- ground noise Ask for a sign lan- guage interpreter if necessary Write down what clients do not un- derstand 29. Fractures: Care for a new Cast Show the proce- dure on a doll Assist with crutch- es and use Assess for warmth Assess skin Apply ice for 24hrs Assess Neuro Status Elevate the cast for the first 48 hours to prevent swelling Cover area of cast with plastic Use mole skin over rough areas Provide skin and perineal care The cast will feel warm but will not burn client Report pain that is not relieved in one hour Turn client every 2 hrs to dry Monitor for drainage Teach the parent to per- form neuro checks 30. Preparing the body for viewing Maintain privacy Remove all tubes Remove all per- sonal belongings to be given to the family Cleanse and align the body supine with a pillow under the head Place the arms outside of the blanket palms down, Keep dentures in place Close eyes Apply fresh linens with absorbent pads on bed and a gown Brush the client's hair, Place hair pieces Remove excess supplies, equip- ment, and soilded linens Dim the lights and minimize noise 31. Necessary Loss: A loss related to a change that is part of the cycle of life 32. Actual Loss : Any loss of a val- ues person, item or status 33. Perceived loss: Any loss that is not obvious to others 34. Maturational or developmental loss: Any loss expected of life. (Child leav- ing for college) 35. Situational loss: Any unanticipated loss caused by an external event (home loss by tor- nado) 36. Anticipatory loss: Experienced be- fore the loss hap- pens 37. Stages of grief Denial, Anger, Bargaining, De- pression, Accep- tance. 38. Advance directives: Legal documents that direct end of life issues 39. Living Will: Directive docu- ments for medical treatment per the client's wishes 40. Health Care Proxy/Durable Power attorney: A document that appoints someone to make medical decisions when the client is no longer able to do son on his own be- half. 41. Rest and Sleep—Promoting Sleep Factors that interfere with sleep Illness: Can re- quire more sleep or disrupt sleep Current life events: Traveling or work hours change Emotional stress: Anxiety, fear, grief Diet: Caffeine con- sumption, heavy meals before bed- time