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FON 1
| Question | Answer |
|---|---|
| describe what a nursing theory is | a conceptualization of some aspect of nursing that describes, explains, and prescribes care |
| what is a theory | it describes why something happens, defines concepts, explains relationships, predicts outcomes, guides nursing actions |
| what is the relationship between: theory, research, and practice | theory drives research, research tests theories, and practice applies theories and research to patient care |
| what are the components of a theory | phenomenon, concept, definition, and assumptions |
| what is a domain | perspective of the profession/boundaries |
| what are the 4 parts of the nursing metaparadigm | person, health, environment, and nursing |
| define the parts of the nursing metaparadigm | person- recipient of care. Health- optimal functioning (not just absence of disease) Environment- all conditions affecting a person Nursing- actions taken to help the person |
| describe nightingales theory | Environmental theory: the environment influences healing Ex. light, linen, air, bedding, etc |
| describe leininger's theory | culture care theory: culturally congruent care |
| describe Orem's theory | self-care theory: patients who participate in self-care are more likely to improve their health outcomes |
| describe Parse's theory | theory of human becoming: health is personal, nurse's role is to support/honor a patient's meaning and choices |
| describe Roy's theory | adaptation model theory: people are adaptive systems and we all react differently to stimuli in physiological, role function, self-concept, and interdependence |
| describe Peplau's theory | Theory of interpersonal relations: patient's experiences and the effect the nurse-patient relationship has on them |
| describe Watson's theory | Theory of human caring: holistic and humanistic core of nursing, focused on human relationships |
| describe Pender's theory | theory of health promotion: describes health as positive, dynamic state, not just the absence of disease |
| what are different types of nursing theories | Grand, middle-range, practice, descriptive, prescriptive |
| describe shared theories | a theory developed in another discipline that nurses apply/or other fields use as well |
| describe grand theory | abstract, broad, hard to apply directly without interpretation |
| describe middle-range theory | more specific, less abstract, focuses on a particular phenomenon |
| describe practice theory | very specific, situation specific |
| describe descriptive theory | describe phenomena, does not guide interventions |
| describe prescriptive theory | guides interventions/predicts outcomes |
| which theory is the most abstract | grand theory |
| give examples of each of the types of theories | Grand- nightingale, Orem, Parse, Roy, Watson Middle- Leininger, Peplau, Pender Practice- pain management protocol Descriptive- theories of growth and development, Prescriptive- Wiedenbach's prescriptive theory of the helping art of nursing |
| example of a shared theory | Maslow's hierarchy of needs, |
| explain quality improvement | a continuous process that uses data to improve health care quality and safety |
| what does quality improvement use to gain data | nurse sensitive quality indicators, HCAHPS, and core measures |
| explain the history of QI: why it became important? | from two key reports released from the institute of Medicine: To Err is human- 98000 deaths a year from medical errors and crossing the quality chasm- 17 yr delay between evidence and practice |
| what are the six dimensions of healthcare quality | STEEEP- safe, time, equitable, efficient, effective, patient-centered, |
| explain the definitions of the six dimensions of health care quality | safe- do no harm, timely- avoid delays, effective- evidence based practice, efficient- avoid waste, equitable- no disparities, patient-centered-respect patient preferences |
| what are incentives for quality care: regulatory and accreditation agencies | 1. centers for medicare and medicaid services: pay for performance, core measures, conditions of practice 2. the joint commission: national patient safety goals, accredition |
| explain nurse sensitive quality indicators | measure the quality of nursing care, provide the data that arrives QI improvement efforts in hospitals |
| what are the types of nurse sensitive quality indicators | structure, process, and outcome indicators |
| explain structure indicators | reflect the setting, care provided, and available human resource materials (turnover, rn education, turnover) |
| explain process indicators | reflect how care is provided, established by policies and procedures (falls, pain reassessment, restraints) |
| explain outcome indicators | reflect desired client outcomes related to the standard under review (CAUTI, CLABSI, pressure injuries, readmissions) |
| what are HCAHPS | hospital consumer assessment of healthcare providers and systems: measures patient satisfaction through surveys |
| what are core measures | national standards of care/treatment processes |
| what are the three major improvement models in QI | model of improvement, lean model, and six sigma model |
| what are the steps in the model of improvement | Three questions: 1. set an aim 2. measures 3. interventions PDSA cycle: plan, do, study, act |
| describe the three questions in the model of improvement | 1. set an aim: what are we trying to accomplish? 2. measures: how will we know a change is an improvement? 3. interventions: what change can we make that will result in an improvement? |
| describe the parts of the PDSA cycle | Plan: develop a plan to test the change Do: run the test on a small scale Study: analyze results Act: adopt, adapt, or abandon |
| what are the 3 S's of the PDSA cycle | single step, short duration, small sample size |
| describe the lean model | focused on reducing the waste of time and resources |
| describe the six sigma model | focused on reducing variation, includes the DMAIC cycle: define, measure, analyze, improve, and control |
| what does EBP integrate | research evidence, clinical expertise, and patient preferences values |
| what are the benefits of EBP | higher nurse satisfaction, reduces costs, better patient outcomes, uses best science/evidence |
| nursing theory vs research | nursing theories form the basis of research and research uses theories to get credibility and produces evidence from the theories |
| EBP vs research | EBP uses existing evidence from research, research generated evidence |
| what are the steps of the scientific research | 1. observe a problem 2. review the literature 3. develop a hypothesis 4. design an experiment 5. conduct the experiment 6. analyze the results 7. formulate recommendations and release findings |
| what are elements of research articles | abstract, intro, lit review/bachground, manuscript narrative |
| what are the two types of research literature | primary and secondary |
| describe primary literature | original research studies, provide raw evidence, quantitative, qualitative, and mixed methods |
| explain the difference between qualitative and quantitative research | qualitative: phenomenology, grounded theory, ethnography quantitative: RCT's, quasi experiments, cohorts, surveys |
| describe secondary literature | summaries of multiple primary studies- author is not conducting original research. Systematic reviews, systematic review with metaanalysis, clinical practice guidelines, literature reviews, expert opinions |
| explain the hierarchy of evidence | a pyramid where the top has more reliability bottom has the least |
| explain the 7 levels of evidence | 1. systematic review of RCTs, systematic review of nonRCTs 2. single RCT, single nonRCT 3. systematic review of correlational/observable studies 4. single correlational/observable study 5. systematic review of descriptive/qualitative/physiologic studies |
| what is a PICOT question | one that uses population, intervention, comparison, outcome, and time |
| what are the steps of evidenced based practice | 0. cultivate a spirit of inquiry 1. ask a clinical question in PICOT format 2. search for relevant evidence 3. critically appraise the evidence 4. integrate the evidence 5. evaluate the outcomes of practice decisions or change 6. communicate the outcomes |
| explain the history of florence nightingale | created the first nursing theory, nicknamed the lady with the lamp during the crimean war, created the first nursing school in london |
| who created british hotels, and was denied entry into the nightingale | mary seacole |
| who set up the american cross | clara barton |
| who organized hospitals, nurses, and supplies during the civil war | dorothy dixon |
| who organized ambulances during the civil war | mother bickerdyke |
| who was part of the underground railroad and helped save over 300 slaves | harriet tubman |
| what are some nursing challenges | nursing shortages, increased costs, rise in chronic illness, higher life expectancy, expanding technology |
| where was the first nursing school in the us established | in new york in 1873 |
| who was the first professionally trained african american nurse who was focused on cultural diversity and awareness | mary mahoney |
| history of the great depression | economic crash, social security, foundation for medicare and medicaid, nurses responding to community needs |
| history of the 1960s | medicare and medicaid act, mental health centers act, nurses moving into hospitals, public health positions, and home health |
| history of the 1980s and 90s | advanced practice nursing roles, male nurses entering the profession, magnet recognition program, rising research growth and costs |
| advanced practice registered nurses include | research nurses, nursing professors, clinical nurse specialist, certified nurse midwife, nurse practitioner, certified nurse anesthetist |
| what are two parts of nursing | art and science |
| explain the art of nursing | relationships with patients, compassion, care, interaction |
| explain the science of nursing | knowledge and continuing education, research |
| when was the ANA established | 1911 |
| standards | authoritative statements of the duties performed by all nurses |
| 3 parts of the standards of nursing | standards of practice, standards of professional performance, and code of ethics |
| professional responsibilities/roles of nurses | autonomy, caregiver, patient advocate, educator, communication, manager |
| explain ANA standards of practice | tells you how to practice competently, forms foundation of nurse decisions |
| what is the critical thinking model for standard of practice | assessment, diagnosis, outcome, planning, implementation, evaluation (ADOPIE) |
| explain ANA standards of professional performance | describes competent level of professional behavior |
| what is the list of noted skills in standards of professional performance | 1. ethics 2. advocacy 3. respectful and equitable practice 4. communication 5. collaboration 6. leadership 7. education 8. scholarly inquiry 9. quality of practice 10. professional practice evaulation 11. resource stewardship 12. environmental health |
| explain the ANA code of ethics | the philosophical ideas of right and wrong that define principals used to provide care |
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