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IV Therapy - WK1

The LPN w/ Card may inject Normal Saline Flush Heparin Saline Flush
The LPN w/ Card may change Peripheral IV tubing
The law you must know ORC 4723.17(C1)
Competency “a determination of an individual’s capability to perform expectations”
Standardized performance measures Clinical skills checklists/competency assessments Continuing education credits Documents that verify training and education References from previous employers
employer expectations (9 areas to meet expectation) Possess the necessary theoretic background for safe client care and decision making; Use the nursing process in a systematic way; Recognize own abilities and limitations; Use communication skills effectively; Work effectively with assistive personnel, d
Infusion nursing nursing process relating to technical and clinical application of fluids, electrolytes, infection control, oncology pediatrics, pharmacology, quality assurance, technology and clinical application, parenteral nutrition, and transfusion therapy
Three-Part Competency Model Competency statement; Domains of learning criteria; Evaluation and learning outcomes
Competency statement Statement that reflects a measurable goal
Domains of learning criteria Cognitive (knowledge based) Performance criteria (psychomotor skills)
Evaluation and learning outcomes Written tests Return demonstration Precepted clinical experience
Evidence-based nursing practice (EBNP) Conscientious use of current best evidence in making decisions about patient care
Evidence-Based Model Select a topic Find and critique the evidence Adapt the evidence for use in a specific practice environment Implement the EBP Evaluate the effect on patient outcomes
Nursing Process Related to Infusion Therapy assessments, analysis, planning, implementing client care, evaluation
Assessment includes Collection of data Critical laboratory values Allergies Environmental issues Presence of adverse reactions or complications
Subjective Information r/t Infusion Therapy Patient’s related fears of infusion Patient’s experiences with prior infusion therapy Patient’s needs and stated preferences Disclosure of indications, including anticoagulants
Objective information r/t Infusion Therapy Review of patient’s past and present medical history; Physical assessment, including evaluation of periphery for poor vascular return; Review of laboratory data and radiographic studies; Assessment of level of growth and development for neonate and pediat
Diagnosis Examples of infusion-related problems Fluid volume deficit related to failure of regulatory mechanism Infection, risk for related to compromised host defenses
Planning involves three components Setting priorities Writing expected outcomes Establishing appropriate interventions
Nursing Outcomes Classification (NOC) Outcomes can be developed in two ways Using the nursing outcomes classification (NOC) list Developing an appropriate outcome statement or you can make it up
Nursing actions Interventions are the concepts that link specific nursing activities and actions to expected outcomes Independent activities are those actions that the nurse performs using his or her own discretionary judgment Collaborative activities are those actions
Examples of Nursing Actions R/T Infusion Therapy Adherence to established infection control practices; Preparation of infusate solutions with medication additives; Initiation of appropriate actions in the event of adverse reaction to medication; Documentation of all care delivered
Evaluation loops back to assessment; Once new data is collected a nursing judgment is made on what modification in the plan of care is needed
Three judgments can be made r/t evaluation The evaluation data indicates that the health-care problem has been resolved Revise the plan of care; outcomes have not been met Continue the plan of care based on progress toward goal
Civil law legal law affecting rights of people or corporation; “i'm going to sue you”
Criminal law offense against the gen public which can cause harm to society – results in imprisonment, fines, etc
Expert testimony the role of an expert is to educate the judge on proper standards of nursing – this helps show autonomy – no one can judge the practices of a nurse except for a nurse
Liable rule of personal accountability – every person is accountable to their own tortuous conduct
Malpractice type of negligence (professional misconduct; unreliable lack of pro skill; or non- adherance to accepted standard of practice; have to cause injury {must be able to prove caused by your actions}– must have all 4 components to be considered
Negligence failure to use such care as a reasonably prudent and careful person would use in similar circumstances
Statute formal written enactment of a legislative authority that governs a state, city, or count
Tort private wrong by act or omission (intentional tort: false imprisonment, hitting a pt, hippa violation, forcing a pt to have an iv if they don't want to have one --- things done on purpose to cause harm) – omission is unintentional – same results
Four primary sources of law Constitutional, Statutory, Administrative, Common
Constitutional law formal set of rules and rights
Statutory law AKA Legislative laws – laws written by fed state of govt – Medicare and Medicaid laws – state reg. Law
Administrative law created by admin. Agencies: Ohio board of nursing laws is an example
Common law court made laws – Malpractice is now a common law – case by case basis – determined by the court
Standards of care describe the results or outcomes of care and focus on the patient; measure quality based on expectations; can be voluntary or mandated by legislation
Breach of duty malpractice w/ pt care cases are mostly d/t nurse negligence care --- deviation from a standard of card; you can do jail time, be fined or lose license and/or job
Legal perils related to infusion therapy practice Failure to monitor and assess clinical status Failure to prevent infection Failure to use equipment properly Failure to protect the patient from avoidable injury
Codes of ethics acknowledges the acceptance of responsibilities and trust that society has outlined the duties and obligations to that trust
Autonomy right to self-determination,independence
Beneficence Doing good to patients
Nonmaleficence Doing no harm to patients
Veracity truthfullness
Fidelity obligation to be faithful
Justice fair to all people
Total quality management (TQM) mgt system focused on improving @ all levels – max. customer satisfaction; doing the right thing
Quality improvement (QI) taking total quality mgt and breaking down into 5 steps
Priority to benefit all pts as well as all internal and external customer
Structure any mechanism that provides support to the people giving care (bldg, money, etc.)
Process what is done when we give the care – actions and events; must be goal directed
Outcome shows effect of care r/t pt
6 goals of Quality/Performance Improvement Process prevent complication -decrease morbidity and mortality -decrease cost -shorten hospital stay -increase pt comfort -increase pt knowledge
Audits official exam of records, process and structure to evaluate performance
Benchmarking how we compare to other hospitals that are similar in our area (apples to apples)
Sentinel Event Review any unexplained occurrence involving death or serious physical and/or psychological injury to pt; sentinel event is something that needs to be reviewed immediately (Med errors, pt suicide, death while pt is in restraint use; assault of the pt, wrong site
Patient Satisfaction Data satisfaction survey after discharge of a pt
Pay for Performance reward based on performance
Risk management concepts hospital prevention of money loss
Informed consents provide pt ample info prior to treating that pt; give pt enough info to make an informed decision - the doctor gets this from pt
Unusual occurrence reports filled out every time there is a deviation from the standard of care – pt harm/injury doesn't need to occur – not part of pt file
Bar code medication administration (BCMA) code on med and on the pt --- if it's the wrong pt med, it will beep @ you “incorrect pt”
Real-time visibility TV/Computer system intergrated – Docs can see pts w/out having to be there
Radiofrequency identification tags (RFID) can store a ton of info – read w/ a scanner; last longer; can be xrayed – usually used w/ chemo drugs and the cancer treatment centers
goal broad statement of a desired outcome
Created by: MarieG