POTTER AND PERRY’S
Fundamentals
of Nursing
4th edition
Jackie Crisp
Catherine Taylor
Clint Douglas
Geraldine Rebeiro
, Contents
Contributors xvii New Zealand health system and reform
Australian and New Zealand reviewers xxi strategies 25
Preface — to the student xxii Nurses 27
Text Features xxiv Consumers 28
Acknowledgements xxviii Healthcare services 29
Voluntary agencies 30
Common forms of care services 31
Rural and remote healthcare 34
Evolving nursing: nursing and the Allied health services 34
Quality healthcare 36
healthcare environment Conclusion 36
1 Nursing today 2
3 Nursing models for practice 39
Jill White
Alan Pearson
Nursing defined 3
Introduction 40
The history of modern nursing 4
Florence Nightingale 4 Nursing’s disciplinary focus 40
Historical perspectives on Australian and Theory 40
New Zealand nursing 5 Components of a theory 41
Social, economic and political inf luences on Types of theories 41
nursing 8 Nursing models 42
Health reforms 8 Components of nursing models 42
Nursing shortage 8 Historical perspective 43
Evidence-based practice and nursing research 10 Relationship of theory to the nursing process
Nursing as professional practice 10 and client needs 44
Science and art of nursing practice 10 Interdisciplinary theories 45
Professional responsibilities and roles 11 Systems theory 45
Autonomy and accountability 11 Basic human needs 46
Nursing competencies and standards 11 Health and wellness models 46
Career development 12 Stress and adaptation 46
Education and its relationship to nursing careers 14 Developmental theories 47
Undergraduate education 14 Psychosocial theories 47
Postgraduate education 14 Selected nursing theories 47
Continuing and in-service education 14 Nightingale 47
Trends in nursing 15 Peplau’s theory 49
Nursing’s impact on politics and health policy 16 Henderson’s theory 49
Abdellah’s theory 49
2 The healthcare delivery system 19 Levine’s theory 49
Jill White and Frances Hughes Johnson’s theory 49
A brief history of the Australian healthcare Rogers’ theory 50
system 20 Orem’s theory 50
A brief history of the New Zealand healthcare King’s theory 50
system 21 Neuman’s theory 50
A national healthcare system 22 Roy’s theory 51
Area health boards 22 Watson’s theory 51
Further reforms 23 Benner and Wrubel’s theory 51
Healthcare reform 23 Parse’s theory 51
Australian health systems and reform strategies 23 Applying the theories 52
ch00-i-xxviii-9780729541107.indd 5 31/08/12 4:19 PM
, 6 CONTENTS
The link between theory and knowledge Formulation of the nursing diagnosis 95
development in nursing 52 Nursing diagnosis statement 96
Support of the diagnostic statement 98
4 Critical inquiry and practice development 55 Sources of diagnostic error 98
Brendan McCormack and Jackie Crisp
Three levels of nursing inquiry 56 7 Planning, implementing and evaluating
Inquiry involving critical engagement in nursing care 100
everyday practice 56 Bronwyn Jones
Inquiry involving collaborative and ongoing Establishing priorities 101
evaluation of local practice 58 Critical thinking in establishing goals and
Inquiry involving nursing research for expected outcomes 101
advancement of nursing knowledge 59 Goals of care 101
Practice development 63 Expected outcomes 103
Facilitation of practice development 65 Guidelines for writing goals and expected
Person-centredness and person-centred outcomes 103
practice 66 Planning nursing care 105
Taking a PEEP 67 Purpose of care plans 105
Taking a PEEP at people 67 Care plans in various settings 105
Taking a PEEP at practice effects 68 Writing the nursing care plan 106
Taking a PEEP at impact of environment on Critical (or clinical) pathways 107
nursing practice 68 Protocols and standing orders 107
Taking a PEEP at engagement through praxis 68 Critical thinking in designing nursing
The complexity of nursing inquiry 69 interventions 111
Types of interventions 111
Selection of interventions 112
Critical thinking and the implementation process 112
Framing nursing: critical processes in Reviewing and revising the existing nursing
nursing practice care plan 112
Organising resources and care delivery 113
5 Critical thinking and nursing judgment 74 Implementing nursing interventions 114
Bronwyn Jones Achieving a client’s goals of care 115
Introduction 75 Communicating nursing interventions 116
Critical thinking defined 75 Critical thinking skills and evaluation of care 116
Ref lection 75 Evaluation of goal achievement 116
Intuition 77 Care plan revision 118
Clinical decisions in nursing practice 77 Unmet goals 118
Knowledge base 77
Development of critical thinking skills in nursing 79 8 Managing client care 121
Critical thinking processes 79 Patricia Mary Davidson and Louise Hickman
Problem solving 79 Evidence to inform nursing practice 122
Decision making 80 Preparing for complexity 123
Clinical judgment model 81 Chronic care 124
Standards for critical thinking 82 Positive practice environments 124
Critical thinking synthesis 82 The role of the registered nurse 125
Models of nursing care 126
6 Nursing assessment and diagnosis 85 Models of nursing care promoting wellness,
Bronwyn Jones autonomy and self-care 127
A critical thinking approach to assessment 86 Building a nursing team 127
Organisation of data gathering 87 Approaches to delivering nursing care 128
Data collection 88 Approaches to managing client care 129
Types of data 88 Communication among the clinical team 131
Sources of data 88 Philosophy and vision for nurses managing
Methods of data collection 89 client care 132
Interview 89 Leadership skills for nursing students 132
Nursing health history 90 Measuring outcomes of nursing care 132
Physical examination 93 Quality improvement processes for nurses 133
Data documentation 93 Nursing-sensitive indicators 134
Analysis and interpretation of data 93 Skill mix for the student nurse 134
ch00-i-xxviii-9780729541107.indd 6 31/08/12 4:19 PM
, CONT ENT S 7
Legal relationships in nursing practice 171
The law of contract 171
Positioning nursing: professional The nurse–doctor relationship 172
Do no resuscitate orders 173
responsibilites in nursing practice
Workload problems 174
9 Ethics and professional practice 138 Floating 174
Megan-Jane Johnstone Legal issues in nursing specialties 175
Terms and concepts 140 Community health nursing 175
Ethics and morality 140 Emergency department 175
Bioethics 140 Nursing children 175
Nursing ethics 141 Medical/surgical nursing and gerontological
Moral principles 141 nursing 176
Moral rules 141 Critical care nursing 176
Rights 141 Perioperative nursing 176
Moral duties 142 Mental health nursing 176
The importance of ethics 142 Hospital in the home and outreach services 177
Moral conduct in nursing 143 Remote area nursing 177
Moral accountability and responsibility 143 Professional involvement of nurses 177
Guides to ethical professional conduct 144
11 Legal implications in nursing practice
Moral theories 144
Deontological ethics 144 in New Zealand 179
Teleological ethics 145 Elaine Papps
Ethical principlism 145 Regulation of nursing in New Zealand 181
Moral rights theory 146 Continuing competence and annual
Virtue ethics 147 practising certificates 181
Cross-cultural ethics 147 Regulation of nurses from Australia or
other countries 183
Nursing codes of ethics 147
Competence notifications and review 183
Moral problems in nursing 148
Health notifications 183
Nursing point of view 149
Complaints about nurses 183
Distinguishing moral problems from other
Health and Disability Commissioner 184
kinds of problems 149
Health Practitioners Disciplinary Tribunal 184
Identifying and responding effectively to
Sources of law 185
moral problems in nursing 149
Legal liability in nursing 185
Processes of moral decision making 151
Treatment injury 185
Bioethical issues in nursing 154
Exemplary damages 185
Conclusion 157
Torts 186
Negligence 186
10 Legal implications in nursing practice Standards of care 186
in Australia 160 The need for careful documentation 186
Mary Chiarella Confidentiality and privacy 186
Regulation of nursing 161 Obtaining consent 187
Legal and professional boundaries of nursing 161 Use of human tissue and organ donation 188
Sources of law 162 Legal relationships in relation to employment 188
Legal liability in nursing 162 The law of contract 188
Torts 163 Legal issues in nursing specialties 189
Negligence 163 Nursing children 189
Nursing students 164 Mental health nursing 190
Standards of care 164 Professional responsibility of nurses 190
The need for careful documentation 166
Confidentiality and privacy 166 12 Communication 193
Assault and battery 167 Jane Stein-Parbury
The right of the patient to receive Communication and nursing practice 194
information 168 The context of nursing practice 194
The patient’s right to refuse treatment 169 Why nurses need to communicate 194
Dying with dignity 169 Healthcare environments and communication 196
Caring for the dying 171 Patient-centred communication 196
Brain death and organ donation 171 Focusing on solutions 197
ch00-i-xxviii-9780729541107.indd 7 31/08/12 4:19 PM
Fundamentals
of Nursing
4th edition
Jackie Crisp
Catherine Taylor
Clint Douglas
Geraldine Rebeiro
, Contents
Contributors xvii New Zealand health system and reform
Australian and New Zealand reviewers xxi strategies 25
Preface — to the student xxii Nurses 27
Text Features xxiv Consumers 28
Acknowledgements xxviii Healthcare services 29
Voluntary agencies 30
Common forms of care services 31
Rural and remote healthcare 34
Evolving nursing: nursing and the Allied health services 34
Quality healthcare 36
healthcare environment Conclusion 36
1 Nursing today 2
3 Nursing models for practice 39
Jill White
Alan Pearson
Nursing defined 3
Introduction 40
The history of modern nursing 4
Florence Nightingale 4 Nursing’s disciplinary focus 40
Historical perspectives on Australian and Theory 40
New Zealand nursing 5 Components of a theory 41
Social, economic and political inf luences on Types of theories 41
nursing 8 Nursing models 42
Health reforms 8 Components of nursing models 42
Nursing shortage 8 Historical perspective 43
Evidence-based practice and nursing research 10 Relationship of theory to the nursing process
Nursing as professional practice 10 and client needs 44
Science and art of nursing practice 10 Interdisciplinary theories 45
Professional responsibilities and roles 11 Systems theory 45
Autonomy and accountability 11 Basic human needs 46
Nursing competencies and standards 11 Health and wellness models 46
Career development 12 Stress and adaptation 46
Education and its relationship to nursing careers 14 Developmental theories 47
Undergraduate education 14 Psychosocial theories 47
Postgraduate education 14 Selected nursing theories 47
Continuing and in-service education 14 Nightingale 47
Trends in nursing 15 Peplau’s theory 49
Nursing’s impact on politics and health policy 16 Henderson’s theory 49
Abdellah’s theory 49
2 The healthcare delivery system 19 Levine’s theory 49
Jill White and Frances Hughes Johnson’s theory 49
A brief history of the Australian healthcare Rogers’ theory 50
system 20 Orem’s theory 50
A brief history of the New Zealand healthcare King’s theory 50
system 21 Neuman’s theory 50
A national healthcare system 22 Roy’s theory 51
Area health boards 22 Watson’s theory 51
Further reforms 23 Benner and Wrubel’s theory 51
Healthcare reform 23 Parse’s theory 51
Australian health systems and reform strategies 23 Applying the theories 52
ch00-i-xxviii-9780729541107.indd 5 31/08/12 4:19 PM
, 6 CONTENTS
The link between theory and knowledge Formulation of the nursing diagnosis 95
development in nursing 52 Nursing diagnosis statement 96
Support of the diagnostic statement 98
4 Critical inquiry and practice development 55 Sources of diagnostic error 98
Brendan McCormack and Jackie Crisp
Three levels of nursing inquiry 56 7 Planning, implementing and evaluating
Inquiry involving critical engagement in nursing care 100
everyday practice 56 Bronwyn Jones
Inquiry involving collaborative and ongoing Establishing priorities 101
evaluation of local practice 58 Critical thinking in establishing goals and
Inquiry involving nursing research for expected outcomes 101
advancement of nursing knowledge 59 Goals of care 101
Practice development 63 Expected outcomes 103
Facilitation of practice development 65 Guidelines for writing goals and expected
Person-centredness and person-centred outcomes 103
practice 66 Planning nursing care 105
Taking a PEEP 67 Purpose of care plans 105
Taking a PEEP at people 67 Care plans in various settings 105
Taking a PEEP at practice effects 68 Writing the nursing care plan 106
Taking a PEEP at impact of environment on Critical (or clinical) pathways 107
nursing practice 68 Protocols and standing orders 107
Taking a PEEP at engagement through praxis 68 Critical thinking in designing nursing
The complexity of nursing inquiry 69 interventions 111
Types of interventions 111
Selection of interventions 112
Critical thinking and the implementation process 112
Framing nursing: critical processes in Reviewing and revising the existing nursing
nursing practice care plan 112
Organising resources and care delivery 113
5 Critical thinking and nursing judgment 74 Implementing nursing interventions 114
Bronwyn Jones Achieving a client’s goals of care 115
Introduction 75 Communicating nursing interventions 116
Critical thinking defined 75 Critical thinking skills and evaluation of care 116
Ref lection 75 Evaluation of goal achievement 116
Intuition 77 Care plan revision 118
Clinical decisions in nursing practice 77 Unmet goals 118
Knowledge base 77
Development of critical thinking skills in nursing 79 8 Managing client care 121
Critical thinking processes 79 Patricia Mary Davidson and Louise Hickman
Problem solving 79 Evidence to inform nursing practice 122
Decision making 80 Preparing for complexity 123
Clinical judgment model 81 Chronic care 124
Standards for critical thinking 82 Positive practice environments 124
Critical thinking synthesis 82 The role of the registered nurse 125
Models of nursing care 126
6 Nursing assessment and diagnosis 85 Models of nursing care promoting wellness,
Bronwyn Jones autonomy and self-care 127
A critical thinking approach to assessment 86 Building a nursing team 127
Organisation of data gathering 87 Approaches to delivering nursing care 128
Data collection 88 Approaches to managing client care 129
Types of data 88 Communication among the clinical team 131
Sources of data 88 Philosophy and vision for nurses managing
Methods of data collection 89 client care 132
Interview 89 Leadership skills for nursing students 132
Nursing health history 90 Measuring outcomes of nursing care 132
Physical examination 93 Quality improvement processes for nurses 133
Data documentation 93 Nursing-sensitive indicators 134
Analysis and interpretation of data 93 Skill mix for the student nurse 134
ch00-i-xxviii-9780729541107.indd 6 31/08/12 4:19 PM
, CONT ENT S 7
Legal relationships in nursing practice 171
The law of contract 171
Positioning nursing: professional The nurse–doctor relationship 172
Do no resuscitate orders 173
responsibilites in nursing practice
Workload problems 174
9 Ethics and professional practice 138 Floating 174
Megan-Jane Johnstone Legal issues in nursing specialties 175
Terms and concepts 140 Community health nursing 175
Ethics and morality 140 Emergency department 175
Bioethics 140 Nursing children 175
Nursing ethics 141 Medical/surgical nursing and gerontological
Moral principles 141 nursing 176
Moral rules 141 Critical care nursing 176
Rights 141 Perioperative nursing 176
Moral duties 142 Mental health nursing 176
The importance of ethics 142 Hospital in the home and outreach services 177
Moral conduct in nursing 143 Remote area nursing 177
Moral accountability and responsibility 143 Professional involvement of nurses 177
Guides to ethical professional conduct 144
11 Legal implications in nursing practice
Moral theories 144
Deontological ethics 144 in New Zealand 179
Teleological ethics 145 Elaine Papps
Ethical principlism 145 Regulation of nursing in New Zealand 181
Moral rights theory 146 Continuing competence and annual
Virtue ethics 147 practising certificates 181
Cross-cultural ethics 147 Regulation of nurses from Australia or
other countries 183
Nursing codes of ethics 147
Competence notifications and review 183
Moral problems in nursing 148
Health notifications 183
Nursing point of view 149
Complaints about nurses 183
Distinguishing moral problems from other
Health and Disability Commissioner 184
kinds of problems 149
Health Practitioners Disciplinary Tribunal 184
Identifying and responding effectively to
Sources of law 185
moral problems in nursing 149
Legal liability in nursing 185
Processes of moral decision making 151
Treatment injury 185
Bioethical issues in nursing 154
Exemplary damages 185
Conclusion 157
Torts 186
Negligence 186
10 Legal implications in nursing practice Standards of care 186
in Australia 160 The need for careful documentation 186
Mary Chiarella Confidentiality and privacy 186
Regulation of nursing 161 Obtaining consent 187
Legal and professional boundaries of nursing 161 Use of human tissue and organ donation 188
Sources of law 162 Legal relationships in relation to employment 188
Legal liability in nursing 162 The law of contract 188
Torts 163 Legal issues in nursing specialties 189
Negligence 163 Nursing children 189
Nursing students 164 Mental health nursing 190
Standards of care 164 Professional responsibility of nurses 190
The need for careful documentation 166
Confidentiality and privacy 166 12 Communication 193
Assault and battery 167 Jane Stein-Parbury
The right of the patient to receive Communication and nursing practice 194
information 168 The context of nursing practice 194
The patient’s right to refuse treatment 169 Why nurses need to communicate 194
Dying with dignity 169 Healthcare environments and communication 196
Caring for the dying 171 Patient-centred communication 196
Brain death and organ donation 171 Focusing on solutions 197
ch00-i-xxviii-9780729541107.indd 7 31/08/12 4:19 PM
