AH3 Exam - Chapter 1: overview of critical care nursing with verified answers

AH3 Exam 1 - Chapter 1: overview of critical care nursing with verified answers AACN standard of professional performance CORRECT ANSWER - the acute and critcal care nurse unique challenge is to create safety for patients and families who are in the most vulnerable and life threatening situations - Nursing bundles to provide better evidence based on evidence - Quality of practice Professional practice evaluation Education Communication Ethics Collaboration Evidence based practice Resource utilization Leadership and environmental health American association of critical care nurses (AACN) CORRECT ANSWER - professional organization that was established in 1969 to rep critical care nurses - largest nursing speciality organization in the world - dedicated to providing knowledge and resources to those caring for acutely and critically ill patients - established in 1969 - largest nursing speciality organization in the world - standards of practice - certification synergy model leads to better patient outcomes barriers to effective handoff communication CORRECT ANSWER • Physical setting: background noise, lack of privacy, interruptions • Social setting: organizational hierarchy and status issues • Language: differences between people of varying racial and ethnic backgrounds or geographical areas • Communication medium: limitations of communications via telephone, e-mail, paper, or computerized records versus face-to-face benefits of American association of critical care nurses (AACN) membership CORRECT ANSWER continuing education offerings, educational advancement scholarships, research grants, awards, and several official publications - thye post practice alerts with succinct, evidence based practices to be applied at the bedside bundles CORRECT ANSWER - IHI has promoted the concept of this to reduce harm - evidence based best practices that are done as a whole to improve outcomes certification of critical care nurses CORRECT ANSWER - this validates knowledge of critical care, promotes professional excellence, and helps nurses to maintain a knowledge base - AACN certification corporation oversees the critical care certification process - other certifications are available for managers and advances practice nurses -AACN has partnered with the american organization of nurse executives to odder certification for managers and leaders - advanced practice certification is also available - all certifications have eligibility requirements to sit for the examination - the AACN certification credentials are based on a synergy model of practice, which states that the needs of patients and families influence and drive competencies of the nurse compentencies of nurses caring for the critically ill CORRECT ANSWER - clinical judgement and reasoning skills - advocacy and moral agency in identifying and resolving ethical issues - caring practices that ar tailored to the uniqueness of the patient and the family - collaboration with patients, family members, and health care team members - systematic thinking that promotes holistic nursing care - response to diversity - facilitator of learning for patients and family members, team members, and the community - clinical inquiry and innovation to promote the best patient outcome critical care nurse characteristics CORRECT ANSWER - essential nursing practices include monitoring and assessment, reassessment, interpreting information, and problem solving; evaluation of progress to outcomes; development software sustainable evidence based practice; coordination of team activities and the care plan, patient and family education and team skill development - important for critical care nurses to devote time to meet the psychosocial and spiritual needs of patients in addition to the complex physical care - technical competence: equipments, IV pumps - relationship building with colleagues, patient and family - ability to multitask and set priorities: timeliness is very important critical care nursing is concerned with CORRECT ANSWER human responses to life threatening problems, such as trauma, major surgery, or complications of illness - human response can be physiologic or psychological critical carie nursing evolved as a speciality in the CORRECT ANSWER 190s with the developments of general intensive care units - since that ICU units have become very specialized culture of safety CORRECT ANSWER a nonhierarchical culture in which all miners have the opportunity and the duty to ensure safe and effective care - founded on respect and the recognition that each discipline involved in patient care brings distinct skills and perspectives to the table effective communication CORRECT ANSWER - essential for delivering safe patient care - breakdowns often occur during handoff situations = approaches include ask- tell ask - tell me more is a tool and so is SBAR: delivers information in a way that is brief and action oriented - other strategies: standardizing process for the handoff situation, using checklists to promote and document essential information, and training all personnel in effective communication techniques - CRM in flight crews for passenger safety and was developed to promote communication and accountability among team members; situational awareness is also a component electronic intensive care unit CORRECT ANSWER patients are monitored remotely by critical care nurses and physcians - it has reduced hospital and ICU lengths of stay and has reduced mortality healthy work environment CORRECT ANSWER - culture of critcal care unit includes its shared values, attitudes, beliefs, which reflect behavioral norms that guide functional dynamics of staff interactions - ACCN imitated a campaign to create a work envrioenti that is safe, heal thing, and humane - this environment promotes nurse retention - essental components: respect responsibility acknowledgement of the unique contributions of patients, families, nurses, and health care team members mission of American association of critical care nurses (AACN) CORRECT ANSWER - focuses on assisting acute and critical care nurses to attain knowledge and influence to deliver excellent care - vision supports creating a health system driven by the needs of patients and families in which critical care nurses make their optimal contributions, which is described as synergy Quality and Safety Education for Nurses (QSEN) CORRECT ANSWER - provides a road map for integrating quality and safety principles into a prelicensure nursing education - defines six core competencies that provide a foundation by which nurses continuously deliver safe, quality care patient centered care teamwork and collaboration evidence based practice quality improvement informatics saftey quality and safety emphasis CORRECT ANSWER - essential for the cirical care nurse - patient identification - improving communication improving medication saftey - using alarms safely - reducing risk of health care associated infection -identify safety risks - prevent complications associated with surgery and procedures SBAR approach CORRECT ANSWER S- situation: state what is happening at the present time that has warranted the SBAR communication B - background: explain circumstances leading up to this situation. put the situation into context for the reader or listener A - assessment: state what you think the problem is R - recommendation: state your recommendation to correct the problem society of critical care medicine (SCCM) CORRECT ANSWER - multi professional scientific and educational organization - mission is to secure the highest quality care for all critically ill and injured patients - vision is to have a health care system in which all critically ill and injured persons receive care from a multi professional team directed by a intesivist and these teams use knowledge, technology, and compassion to provide timely, safe, effective, and efficient patient care - dedicated to ensuing excellence and consistency in critical care practice through education, research, and advocacy - founded in 1970 - multiporfessional membership includes physicians, nursing, and other cirical care team members standards CORRECT ANSWER - serves as guidelines for clinical practice they establish goals for patient care and provide mechanisms for nurses to assess the achievement of patient goals regardless of the setting for practice - standard of practice go with the nursing process: collect data, determine diagnoses, idenify expected outcomes, develop a care plan, implement interventions, and evaluate progress to goals standards of professional performance CORRECT ANSWER - evaluates the quality and effectiveness of nursing practice - evaluates own practice in relation to professional practice standards and guidelines - acquires and maintains current knowledge and competency in patient care - contributes to the professional development of peers and other health care providers - acts ethically in all areas of practice - uses skilled communication to collaborate with the health care team to provide a safe and healing environment - uses clinical inquiry and integrates research findings into practice - considers factors related to safety effectiveness, cost and effects in planning when delivering care - provides leadership in the practice setting for the profession strategies to reduce hospital readmission rates CORRECT ANSWER - improving care transitions -use of technology : but with this involves ethical issues and nurses must be comfortable addressing ethical issues as they arise in the cirical care setting - palliative care that includes spiritual care is an important intervention that must be embraced by those working in cirical care units synergy model for patients care in the AACN involves CORRECT ANSWER - the patients characteristics matching nurse competencies - in the system there is recidivism, costs and resource utilization - the nurse must see physiologic changes, presence or absence of complications, extent to which care or treatment objectives were attained - in the patient monitoring functional change, behavioral change, trust, ratings, satisfaction, comfort and quality of life t or f another strategy to improve patient safety is the implementation of the rapid response teams or medical emergency teams to address changes in patients conditions CORRECT ANSWER true the goal of these teams is to identify and manage both unstable patients and those at high risk of cardiopulmonary arrest to prevent unnecessary deaths -- critical care nurses are usually leaders of such teams t or f critical care nursing has expanded beyond the walls of traditional care units CORRECT ANSWER ture - they can be cared for in the ER, postanethesia units, step down, intermediate care, and progressive care units - it is also delivered during transport of critically ill patients from the field to the acute care hospital and during interfaculty transport t or f in critical care nursing, the nurse/patient ration is low to ensure that delivery of care is timely and response to treatment is continually assessed CORRECT ANSWER true t or f nurses are encouraged to implement care that is evidence based and to challenge practices that have "always been done" but are not supported by clinical evidence CORRECT ANSWER true t or f the joint commission has identified patient safety goals to be addressed in hospitals, long term care facilities, and other agencies that it accredits CORRECT ANSWER true the AACN certification credentials are based on a synergy model of practice, which states CORRECT ANSWER he needs of patients and families influence and drive competencies of the nurse the focus of critical care uses includes both CORRECT ANSWER the patients and the family responses to illness and involves prevention as well as a cure the ultimate goal of true collaboration in critcal care is to CORRECT ANSWER create a culture of safety - one strategy is implementation of a multi professional bedside round one or two times a shift - patients and families should also be continually updated about the patients condition with this increased frequency of communication - family members are encouraged to participate during tema rounds to facilitate communication and involvement - conducting morning briefings before interdisciplinary rounds is another strategy values of American association of critical care nurses (AACN) CORRECT ANSWER - accountability advocacy integrity collaboration leadership stewadship lifelong learning quality innovation and commitment - values are supported through education, research, and collaborative practice what is critical care nursing? CORRECT ANSWER the ACCN defines acute and critical care nursing as the speciality that manage human responses to actual or potential life threatening problems - must consider physiological and psychological responses focus on patient and family