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Trans. to Practice

Module's 1 & 2

What are the main functions of the Board of Nursing? Protect the public, govern the state's Nurse Practice Act, and to hold hearings to investigate violations
What is the Good Samaritan Act? Provides immunity from liability in certain circumstances
What is the goal of the Good Samaritan Act? Except in cases of gross negligence, is to encourage assistance in emergencies occurring outside of a medical facility
What is the Nursing Standard of Care? Guideline for good nursing
What is the nursing standard of care based on? What an ordinary, prudent nurse with similar education and nursing experience would do in similar circumstance
What is Scope of Practice? Every nurse needs to know what he/she can do
What is the Nurse Practice Act? Law that defines the title and regulates the practice of nursing
Professional Organization In developing standards of care for nursing practice and constantly evaluate existing standards and revise them as needed
Who governs the Nurse Practice Act? Each individual state
Interstate Endorsements (Compact) Makes it possible to work in another state without repeating the NCLEX-PN examination, after you meet the state's criteria for licensure by endorsement
Multi-State Licensure Allows a nurse to have one license in his or her state of residency and practice in other states, depending on each state's Nurse Practice Act and legislation
Malpractice Negligence by a professional (medication & treatment errors, lack of assessment/timely action of condition, defective equipment which causes (or potential to cause) harm, failure to protect the patient)
Negligence Conduct which falls below the standards established by the law for the protection of the patient. (failure to check allergies & patient has reaction to medication)
Abandonment Wrongful termination of patient care (leaving the floor without covering the care of our patient)
Malpractice Insurance Personal policy that includes liability that works for you (the nurse) and not the facility you work in
What are the three factors that can help the nurse avoid malpractice suits? Follow policy, stay within your scope of practice (maintain expertise in practice), and develop a positive nurse/patient relationship
What department has a primary goal to minimize medical error and decrease potential litigation? Risk Management
Criminal Action Involves people and society as a whole and relationships between individuals and government
Civil Action Protects individual rights and results in payment of money to the injured person
Crime Any offense, serious wrongdoing
Tort A violation of civil law, involves a wrong against an individual or his/her property
Misdemeanor Criminal offense defined as less serious than a felony
Intentional Tort Intended to cause harm to the individual
Felony An offense, as murder or burglary of grave character than those called misdemeanor. Imprisonment for more than a year
Unintentional Tort An action that is not meant to cause harm to the patient, but does
Assault Purposely threatened physical harm to an individual
Battery To touch an individual without consent
Harm Injury to a person or the person's property that give rise to a basis for a legal action against that person
Breach of duty Not performing duties according to the standard of care
False Imprisonment Intentionally preventing a competent patient from leaving a facility, restricting his/her movement with the use of physical restraints or chemical use
Defamation Damage to someone's reputation through false communication without their permission
Libel An example of defamation through written communication; keep your opinions out of your charting, just chart the facts
Slander An example of defamation by verbalizing untrue or private information (gossip) or a third party
HIPPA Health Insurance Portability & Accountability Act; main focus is privacy, also gives the rights over their health information (patients are able to view their own medical records, but follow agency policy)
Competency A legal state that a person has reached the age of maturity and can make decisions for herself/himself
Patient Rights Fundamental right for treatment with dignity and compassion
General Consent A person has voluntarily sought admission to a health care facility
Informed Consent Must be obtained for invasive procedures for a therapeutic or diagnostic purpose
Authorized Consent Parent cannot give informed consent for their children, but they can authorize treatment for their children
Confidentiality A duty to protect information about a patient no matter how the information is received (share information only with those involved with the patient's care)
Medical Records Provides data on each patient. It is used for communication by health care providers (chart does not belong to the patient, but is the property of the facility)
Reporting Abuse There are exceptions to the right of privacy {certain communicable diseases, gunshot wounds, signs of abuse (children & older adults)}
Elder Abuse Any needs physical, mentally, or financial that are not met is abuse of older person (withholding food or medication due to confusion)
Advocate A person who acts on behalf of another person
What are nursing ethics? Values and principles governing nursing practice, conduct, and relationships
What is the focus of nursing ethics responsibilities? Ideal behavior, morality, and higher standards (notify physician of improper medical orders that could cause harm to patient; nurse can refuse to carry out the order after notifying physician, but must also notify proper chain of command)
What is accountability? Being responsible for one's actions (accountability errors)
Nomaleficence Do no harm (skin puncture, drug s/e, physical manipulations, product/equipment safety, participate in research)
Beneficence Do good (put patient interest first, place the good of the patient before one's own needs)
Autonomy Right to be independent and make decisions
What are the four steps of autonomy decisions? Thinking through all the facts, deciding on the basis of an independent thought process, acting based on a professional & personal decision, undertaking a decision voluntarily, without pressure from anyone else
Fidelity BE TRUE - acting in patients' best interest when they are unable to make free choices - being faithful to agreements and promises - do what you say, when you say you are going to do it
What is the order in variance of care (incident report)? Provide urgent care & collect data, Notify charge nurse, Call physician, Identify all witnesses, Fill out incident report
What are incident/variance reports? aka: unusual occurrence reports; are completed in the even of an unusual occurrence or accident. Report should include objective, observed information including what happened DO NOT MENTION INCIDENT REPORT IN CHART
Why is the narcotic count done? Keep track of controlled medication
When is the narcotic count completed and by whom? At the beginning and end of each shift by 2 licensed individuals
Delegation Process of transferring a selected nursing task in a situation to an individual who is competent to perform that specific task
Assignment Transferring performance of client care activities to specific staff members
What are some task that a LPN can delegate to a UAP/CNA? Bed making, feeding, bathing, ambulation, applying hearing aid, stocking supplies, turning & repositioning patient, recording I/O, giving enema, filling H20, ROM exercises, taking specimens, transferring patient to chair/bed, oral hygeine
What are the 5 rights of delegation Task, Circumstance, Person, Direction/Communication, Supervision
What is essential to the delivery of nursing care? Communication - essential for the exchange of information about patients, includes needs of patient or changes that have occurred, includes history of events for the patient
How do you avoid misunderstanding's & disagreements with co-workers? Understanding job descriptions
Who can transcribe physicians orders in nursing home? Nurse
Who can transcribe physicians orders in acute care setting? Nurse/Unit clerk/secretary
What is the best practice if orders are unclear? Clarify orders with physician
What is good to have/do for your 6 mos. & annual job evaluations? Read & have copy of job description
Who is held accountable for all the nursing actions that you perform or are assigned to perform? You are
What are reasons for disciplinary action? Drug & alcohol use, fraud & deceit, negligence, criminal activity, incompetence, violation of NPA, disciplinary action by another jurisdiction, and unethical conduct
What are the 4 steps in disciplinary action? Sworn complaint, Complaint reviewed, Finding not guilty, Finding guilty
Autocratic Style Retains all authority - displays little trust in staff, concerned primarily w/task & goals accomplished, one-way communication w/group
Democratic Style People-centered approach - allows more control & participation in the decision making process; works best with mature employees who work well together as groups
Laissez-Faire "Free-run style" or permissive leadership - relinquishes control completely to the team - wants everyone to feel free to "do their own thing" - avoids responsibility by delegating all decision making to the group
Situational Leadership Takes into account the style of the leader, the maturity of the group, and the situation at hand to perform a comprehensive approach
What are "written" orders? Recorded on the chart by the physician; NEVER guess, if in doubt, call physician - if you still believe orders are inappropriate, contact your supervisor
What are "verbal/telephone" orders? May only be taken from physician or nurse; are subject to more error. Clarify order by repeating it to the person giving it (repeat more slowly if needed)
What are charting guidelines? Date & time each entry, must be legible (spelled correctly), use black in, signature after each entry, DO NOT delete notes (report accidental computerized deletions to supervisor)
Physician's Office Opportunity focus on disease prevention and patient teaching, salary tends to be lower, schedule is primarily days with minimal weekends
Temporary Agencies Salary is good, must be highly flexible, right to refuse assignment, wealth of variety available, more flexibility in personal schedule, uncertainty of work available, always an outsider
How do you prioritize patient care? Decide which needs/problems require immediate action & which could be delayed (use ABC's as guide) Patients with life-threatening needs that could result in harm are higher
What are general client problems that usually indicate priority? Fresh post-op, pts whose status has deteriorated from baseline, pts exhibiting signs of shock, patient w/allergic reaction, pts w/chest pain, pts who have returned from diag., pts who verbalize unexpected symptoms, pts who have equip/tubing malfunctions
Who can administer blood? RNs - can spike & monitor for reactions for the first 15 minutes, then LPN can monitor
Who verifies blood products? 2 licensed persons
Who is responsible for notifying charge nurse if they are floated to another unit and are unfamiliar with specific skills needed for that unit? Nurse
What is the supporting documentation for SRD's? Reason for restraint, explanation to patient & family type of device used, patient's response, and restraint must be tied to bed frame and not railing
Created by: tandkhopkins
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