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Midterm (Lec)
communication, tissue integrity, CJ
| Question | Answer |
|---|---|
| CJ definition | the observation outcomes of critical thinking and decision making. the knowledge to: -obs and assess presenting situation -ID a prioritized clt concern -generate EBP solutions to deliver safe care |
| Studies find that novice nurses feel | -unprepared -lack clinical reasoning and judgement -lack of ID significant data and responding in confidence |
| Benner's stages of nursing proficiency | -novice -advanced beginner -competent -proficient -expert |
| novice | student/new grads - follows strict rules -need directions |
| advanced beginners | nurse of <1 yr -some knowledge but rely on seasoned nurses -lack prioritization and management knowledge |
| competent | nurse of 2-3 yrs -better organization/prioritization -can still be thrown off by sudden change |
| proficient | nurse of 3-5 yrs -begin to expect certain issues -uses knowledge and experience to solve |
| expert | nurse of 5+ yrs -usually in a specialized area -rely on experience rather than rules |
| nursing process | ADPIE |
| NCSBN model | 1. recognize cues 2. analyze cues 3.prioritize hypothesis 4.generate solutions 5.take action 6.evaluate outcomes |
| caputi's 5 competencies | 1. get info 2. make meaning of info 3.determine action to take 4.take action 5.evaluate outcomes and thinking |
| why is CJ important | -promos reflective learning -enhances critical thinking -IDs knowledge gaps -builds confidence -encourages teamwork -reinforces the CJ process |
| getting the info steps | 1.determine important info 2.scanning environment 3.ID signs and symptoms 4.assess systematically and comprehensively 5.ensure accurate data |
| what pt info should be gathered | 1.basic pt info 2.medication 3.pt hx (prev hospitalization or illness) 4. diagnostic test |
| what is basic pt info | -age -date and reason for admission -surgical procedures -diet and activity -VS (current and trending) -diagnostic procedures |
| what info should be documented for all pt meds | -drug prescribed -effects expected -results pt has experienced -reason for prescription -adverse effects to monitor |
| what should be documented with diagnostic test | -name of test -reason for order -results -trending of results (if available) |
| what should you scan the environment for | safety of the pt and nurses - what do you see, hear, smell, and feel? - what factors effect the pt |
| What else should you assess in an environment | what potential equipment may you need in a pt room |
| signs vs symptoms | signs: can be measured (objective) symptoms: what the pt/family relays (subjective) |
| what do signs and symptoms tell you? | -what assessments may be needed -what may the pt need to be educated on |
| how should you organize the data you gather (assessing systemically and comprehensively) | -what's normal/abnormal -what needs further investigation |
| how do you ensure your data is accurate | -is the equipment being used/working correctly -does the data look correct |
| communication definition | A complex, ongoing, interactive process that forms the basis for building trusting interpersonal relationships that impacts the provision of health care. |
| communication in nursing | The Nurse of the Future will interact effectively with patients, families and colleagues, fostering mutual respect and shared decision making, to enhance client satisfaction and health outcomes. |
| scope of communication | -effective -moderate -basic -minimal -none |
| communication categories | -linguistic/verbal -paralinguistic/nonverbal -meta-communication |
| linguistic/verbal | exchange of messages through spoken words and written symbols. -requires clear, concise language, considering the patient’s health literacy and avoiding medical jargon |
| paralinguistic/nonverbal | Nonverbal exchange of symbols (Gestures, eye contact, facial expressions, posture) -conveys emotions and attitudes, influencing how messages are received. |
| meta-communication | all factors that affect communication (the sum of your verbal and non-verbal communication) |
| what can affect your verbal communication | -tone -stance -facial expressions -gestures |
| meta-communication example | A patient stating they have no pain, but grimaces and flinches when reaching for their cell phone on the bedside table |
| what occurs during communication | delivery of a message b/t a sender and receiver (a complimentary exchange) |
| sender role | encodes and delivers message |
| receiver | decodes the message |
| what terms should we use when communicating with pts | lay terms (avoid medical jargon) |
| phases of therapeutic relationship | -introductory (admission) -working (stay) -termination (discharge) |
| introductory phase | trust and rapport are established ● Introduce yourself and clarify your role. ● Establish the purpose of the interaction. ● Set goals and boundaries. ● Assess the patient’s needs and concerns. |
| working phase | nurse and pt actively work together to address pt needs ● Provide education and care. ● Encourage the patient to express their feelings. ● Foster problem-solving and coping strategies. |
| termination phase | nurse and pt relationship ends after care goals are met/pt discharge ● Summarize progress and goals achieved. ● Prepare the patient for discharge or transition to another healthcare setting. ● Encourage the patient to express any final concerns. |
| pt centered care definition | recognize the pt or designee as a source of control/ a partner in providing compassionate and coordinated care -based on respect for pts: preferences, values, and needs |
| types of difficult communication | • Nurse-patient/patient-nurse interaction • Angry, sad/anxious patients/family members • Angry or frustrated nurses or other members of the health care team |
| what does effective communication lead nurses to do | understands the concerns of the patient |
| Sharing observations | The nurse openly informs the patient of the assessment and observations |
| Using Silence | Accepting pauses or silences that may extend for several seconds or minutes without interjecting any verbal response. |
| Focusing | Helping the patient expand on and develop a topic of importance. |
| Changing Subject | Directing the communication into areas of self-interest rather than considering the patient’s concerns. |
| Clarifying | Helping the patient clarify an event, situation, or happening in relationship to time. |
| Belittling | a form of aggressive communication that seeks to embarrass, humiliate, or control the recipient. |
| Open-ended Question | Asking broad questions that lead or invite the patient to explore (elaborate, clarify, describe, compare, or illustrate) thoughts or feelings. |
| Restating | Actively listening for the patient’s basic message and then repeating those thoughts and/or feelings in similar words. |
| Being defensive | Attempting to protect an individual or healthcare service from negative comments. |
| False reassurance | Using clichés or comforting statements of advice as a means to reassure the patient. |
| Offering Self | Suggesting one’s presence, interest, or wish to understand the patient without making any demands or attaching conditions |
| Agreeing or disagreeing | agreeing and disagreeing imply that the patient is either right or wrong and that the nurse is in a position to judge this. |
| General Leads | Encourage patients to verbalize and choose topics. |
| Being Specific | Use precise statements to avoid ambiguity. |
| Perception Checking | Verify how a patient experiences a situation. |
| Giving Information | Provide factual information directly. |
| Acknowledging | Recognize changes or efforts nonjudgmentally. |
| Reflecting | Direct ideas back to patients to explore their feelings. |
| Summarizing | Clarify main points to plan future care. |
| Exploring | Investigate feelings related to a subject. |
| Stereotyping | Offering generalized and oversimplified beliefs about groups of individuals based on limited experiences, which negates their uniqueness. |
| Challenging | Making patients prove their statements or points of view, which can make them feel defensive. |
| Probing | Asking for information out of curiosity rather than to assist, often violating privacy. |
| Testing | Asking questions that force the patient to admit something, often meeting the nurse's needs rather than the patient's. |
| Rejecting | Refusing to discuss certain topics, making patients feel rejected. |
| Passing judgment | Giving opinions that imply the patient must think as the nurse does, fostering dependence. |
| Giving advice | Telling the patient what to do, denying their right to be an equal partner. |
| SBAR | -situation (what is happening now) -background (what happened in the past) -assessment (perceived/determine problem) -recommendation (suggestions/plan of care) |
| situation (SBAR) | -ID yourself anf pt -clearly state the issue at hand -ex. hello, my name is __ on ___(ward). Mrs. Hussein in room 2 is experiencing dyspnea and chest pain |
| background (SBAR) | -provide RELEVANT background information (recent proc or changes in condition) -ex. Mrs. Hussein had a PEG placement today |
| assessment (SBAR) | offer analysis or Dx based on info -ex. I think she may be having a cardiac event or pulmonary embolism |
| recommendation (SBAR) | suggest actions/interventions -ex. I recommend you see the pt ASAP and start her on O2 stat |
Created by:
tabithaj23