NURS 311 Clinical Nursing Skills Exam 1 2025

Extensive education Theoretical body of knowledge Specific service Autonomy in decision-making Code of ethics - -Characteristics of a profession? American Nurses Association; professional nursing organization - -What is the ANA ANA Code of Ethics 1 - -practices with compassion and respect for the inherent dignity, worth, and unique attribute of every person ANA Code of Ethics 2 - -The nurse's primary commitment to the patient, whether an individual, family, group, or population ANA Code of Ethics 3 - -The nurse promotes, advocates for, and protects the rights, health, and safety of patient ANA Code of Ethics 4 - -The nurse has authority, accountability, and RESPONSIBILITY for nursing practice; makes decisions; and takes action consistent with the obligation to promote health and to PROVIDE optimal care ANA Code of Ethics 5 - -The nurse owes the same duties to self as to others, including the responsibility to promote health and safety, preserve wholeness of character and integrity, maintain competence, and continue personal and professional growth ANA Code of Ethics 7 - -The nurse, in all roles and settings, ADVANCES THE PROFESSION through research and scholarly inquiry, professional standards development, and the generation of both nursing and health policy ANA Code of Ethics 9 - -The profession of nursing, collectively through its professional organizations, must articulate nursing values, maintain the integrity of the profession, and integrate principles of social justice into nursing and health policy ANA Scope and Standards of Care - -These are not laws but influence policy development State Nurse Practice Act - -NURSING LICENSURE.It's the Law! Define the scope of practice within each state; protects public NURSING To practice nursing in the United States, RN candidates must pass the NCLEX-RN exam Same exam in every state Regardless of educational preparation, the exam is the same Tests minimum knowledge base Delegation - -__________ is a professional practice role of the RN. It is a right and responsibility Nursing Process: Diagnosis, Assessment, Planning, and Evaluation (DAPE) Patient Education (LPNs may reinforce education) Tasks that require clinical judgment and critical thinking - -RNs CANNOT delegate: Delegation Principle - -The decision of whether or not to delegate or assign is based upon the judgment concerning the condition of the patient, the competency of the members of the nursing team, and the degree of supervision that is required of the RN if a task is delegated. Delegation Principles - -The RN delegates only those tasks for which she or he believes that the care worker has the knowledge and skill to perform, taking into account training, cultural competence, experience, and facility policy and procedures. 1: ADLs 2: non sterile specimen collection 3: I&O 4: vital signs - -What may be delegated to nursing assistive personnel (NAP)? The needs or condition of the patient Potential for harm Stability of the patient's condition Complexity of the task Predictability of the outcome Abilities of the staff to whom the task is delegated - -The RN delegates tasks based on: responsibility - -You can delegate ___________ NURSING NURSING NURSING accountability - -You cannot delegate - -Throughout each chapter are guidelines for delegation and collaboration. Be sure to review for each assigned chapter The best evidence comes from well-designed, systematically conducted research studies found in scientific journals. You must also use sources of evidence that include quality improvement and risk management data, infection control data, retrospective or concurrent chart review, and clinicians' expertise. - -How to recognize best evidence when reviewing research 1) Ask a clinical question 2) Collect the most-relevant and best evidence 3) Critically appraise the evidence you gather 4) Apply or integrate evidence along with your clinical expertise, patient preferences, and values in making a practice decision or change 5) Evaluate the practice decision or change 6) Communicate your results - -What are the 6 steps of EBP? Identifying your patients by age, gender, ethnicity, disease, or health problem (P= Patient population of interest). Then ask which intervention do you think is worthwhile to use in practice (e.g., a treatment, diagnostic test, prognostic factor) (I= intervention or issue of interest). Next, ask which standard of care or current intervention do you usually use now in practice? (C=Comparison intervention or issue of interest). Fourth, ask which result do you wish to achieve or observe as a result of an intervention (e.g., change in patient's behavior, physical finding, change in patient's perception)? (O=Outcome). Lastly, how long does it take for an intervention to achieve the outcome? (T= Time) - -How to write a PICO question P: population of interest I: Intervention of interest C:Comparison Interest O:Outcome T: Time - -What does PICOT stand for? systematic review - -A systematic review explains if the evidence for which you are researching exists and whether there is good cause to change practice. Panel of experts reviews all of the evidence from RCTs and summarizes the data! PubMed, CINAHL, Cochrane Database - -Where can I find a systematic review (which database)? PudMed, CINAHL, MEDLINE, Cochrane, EMBASE - -Know which databases contain searchable scientific literature - -Safety and Infection Control NURSING NURSING - -Safety equipment and fall precautions Never events - -Refers to particularly shocking medical errors (such as wrong-site surgery) that should never occur. core measures - -set of care standards; the percentage of eligible patients that receive care represented by the measure. For example: The percentage of AMI patients that receive aspirin on arrival. Basically describes the basic care that should be provided to the patient in the hospital. Building A Safer Health System goal was to reduce in-hospital errors by 50% over next 5 years. 44,000 to 98,000 patients died annually in 2000, 2001, and 2002 due to preventable medical errors (HealthGrades, 2005) 60% of medical errors fell into three areas: infection following surgery, HAIs, failure to diagnose and treat in time - -IOM report To Err is Human 2000 It ended the period of denial of medical errors It shifted the focus to system problems rather than individual blame It brought a number of stakeholders together It motivated hospitals to make changes in practice - -What did Err is Human do? identify patients correctly improve staff communication use medicines safely use alarm safely prevent infection identify patient safety risk prevent mistakes in surgery - -Be familiar with the National Patient Safety Goals TJC - -First established national patient safety goals Neurologic Disorders; history of previous fall. Urinary Urgency or Incontinence; use of sedatives, antihypertensive and analgesics; history of unsteady gait; use of assistive devices; history of orthostatic hypotension; memory deficits - -What are patient fall risk factors? Assess patient's seizure history (ex. New diagnosis, frequent seizures, seizure within last year. Ask patient to describe frequency of past seizures, presence and type of aura (ex. Metallic taste, Perception of breeze blowing on face, or noxious odor) - -Seizure precaution step 1 Assess for medical and surgical conditions, including history of head trauma, electrolyte disturbances (ex. Hypoglycemia, hyperkalemia) - -Seizure precaution step 2 NURSING NURSING Assess medication history (ex. Antidepressants and antipsychotics). Certain medications lower seizure threshold. - -seizure precaution step 3 Inspect patients environment for potential safety hazards (ex. Extra furniture). Keep bed in low position, side-rails up at the head of bed, patient in side-lying position when possible - -seizure precaution step 4 Assess patient's individual and cultural perspective about the meaning of seizures and their treatment. - -seizure precaution step 5 -Protect from harm (never leave patient, call for help; protect airway but don't force anything in client's mouth; protect head and body from injury from thrashing around) -Observe seizure characteristics and duration -Medicate as indicated - -RN responsibilities during seizure? -Make sure patient receives anticonvulsants on time -Determine patient's triggers and avoid them - -Measures to prevent seizures?