RATED A+
✔✔Pt. self-determination act - ✔✔Requires health care institutions to provide written
info. to
clients concerning the clients rights under state law to make
decisions, including the right to refuse treatment and
formulate advance directives
✔✔Uniform anatomical gift - ✔✔➢ Person who is at least 18 yrs. of age has the right to
make
an organ donation
▪ Make gift in writing with their signature
✔✔Unemancipated minors may not consent to abortions without
one of the following - ✔✔➢ Consent of one parent
➢ Self-consent being granted by a court order
➢ Consent specifically given by a court
✔✔Minors may give consent in the following situations - ✔✔➢ Lawfully married or a
parent
➢ Pregnancy (excluding abortions)
➢ Venereal disease
➢ Drug or substance abuse
✔✔Community based nursing - ✔✔Takes place in a community setting such as the
home or
clinic, where the focus is on the needs of the individual or
family
✔✔Human ecology model - ✔✔▪ Client and immediate family
▪ People and settings that have frequent contact with pt. and
family
▪ Local community and its values and policies
▪ Social systems such as government and church
✔✔Quality assurance - ✔✔▪ inspection oriented (detection)
▪ narrow focus
✔✔quality improvement - ✔✔▪ Learning oriented (prevention)
▪ Cross-functional
✔✔The Joint commission - ✔✔➢ Address the organizations level of performance in key
functional areas, including pt. rights, pt. treatment and
,infection control
➢ Focuses on the organization's ability to provide safe high quality
care but now also requires evidence of actual
performance and continue improvement
✔✔Health policy - ✔✔➢ A set course of action undertaken by governments or health
care organizations to obtain a desired outcome
✔✔Private health policy - ✔✔▪ Made by health care organizations, such as hospitals
and
includes those polices instituted to govern employee
practices and health care services provided by the
organization
✔✔Public health policy - ✔✔Refers to local, state and federal legislation, regulations
and funding r/t health care service delivery and
reimbursement
✔✔Local level - ✔✔Many cities or counties offer a variety of health care
services to meet the needs of their residents
✔✔State level - ✔✔Maintaining a safe meat supply through livestock
inspections, ensuring safe food storage etc.
✔✔Federal level - ✔✔Significant funding for health and disease research;
supplemental funding for education for health
professionals, including nurses and physicians; and
paying for individual health care services through
medicare, Medicaid, SCHIP and the veterans
administration health care system
✔✔Never events - ✔✔Serious and costly errors in health care delivery that should
never happen
✔✔Cleaning - ✔✔Removal of all soil from objects and surfaces
✔✔Disinfection - ✔✔Eliminates many or all microorganisms, with the
exception of bacterial spores from inanimate objects
✔✔Sterilization - ✔✔The complete elimination or destruction of all
microorganisms, including spores
✔✔PICO format for evidence based practice - ✔✔➢ P = patient population of interest
➢ I = intervention of interest
,➢ C = comparison of interest
➢ O = outcome
Example:
▪ Does the use of therapeutic distraction (I) compared with
the standard reorientation to the environment (C) reduce
the incidence of wandering (O) in the clients with
dementia (P)
✔✔Research process - ✔✔➢ Problem identification
➢ Study design
➢ Conducting the study
➢ Data analysis
➢ Use of the findings
✔✔Quality improvement - ✔✔an approach to the continuous
study and improvement of the processes of providing health
care services to meet the needs of clients and others
✔✔Performance improvement - ✔✔an organization analyzes and
evaluates current performance to use results to develop
focused improvement actions
✔✔Model for QI and PI - ✔✔▪ Plan
▪ Do
▪ Study
▪ Act
✔✔Value formation and moral development - ✔✔A value is a personal belief about
worth that acts as a
standard to guide behavior; a value system is an entire
framework on which actions are based and is the backbone
to how one thinks, feels and takes action
✔✔Altruism - ✔✔concern for the welfare of others
✔✔Autonomy - ✔✔right to self-determination
✔✔Human dignity - ✔✔respect for inherent worth and uniqueness
of individuals and populations
✔✔Integrity - ✔✔acting in accordance with an appropriate code of
ethics
✔✔Social justice - ✔✔acting in accordance with fair treatment
, regardless of economic status, race, ethnicity, age,
citizenship, disability or sexual orientation
✔✔Ethical principles - ✔✔➢ 3 principles have been proven to be highly relevant in
bioethics
▪ Autonomy
▪ Beneficence, nonmalefience
▪ Veracity - was thought that telling the truth could be
✔✔➢ Total pt. care - ✔✔▪ Nurses are responsible for planning, organizing and
performing all care
- Nurse maintains high degree to practice autonomy
- RN performs many tasks that could be performed by
caregiver with less training at a lower cost
✔✔Functional nursing - ✔✔Staff members are assigned to complete certain tasks for a
group of pt. rather than care for specific pt.
Tasks are completed quickly and little confusion about
job responsibilities
Care may be fragmented
Caregiver may feel unchallenged
✔✔Team nursing - ✔✔▪ RN functions as a team leader and coordinates a small
group of ancillary personnel to provide care to a small
group of pt.
- Each member of the team is able to participate in
decision making and problem solving
- Pt. is confronted with many different caregivers
- Team leader may not have leadership skills
✔✔Primary nursing - ✔✔- RN assumes 24 hour responsibility for planning, directing
and evaluating the pt. care from admission through
discharge
- High degree of autonomy and feel challenged and
rewarded
✔✔Partnership model - ✔✔▪ Coprimary nursing
▪ Modification of primary nursing
▪ RN is partnered with an LVN, LPN or NAP and the pair
work together consistently to care for an assigned group
of pt.
✔✔Pt. centered care - ✔✔▪ Providing care that is respectful of and responsive to
individual pt. preferences, needs and values and ensuring
that pt. values guide all clinical decisions