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Med surgical ch 1

medical surgical nursing iggy 7e ch1 complete

QuestionAnswer
As a result of the institute of med (IOM) report "to err is human" which national org requires accredited agencies to meet specific national patient safety goals The Joint Commission (TJC)
preventing harm from high alert drugs (anticoagulants, insulin, opioids) is an IHI intervention to prevent patient harm.
Ask a trusted family member or friend to be your advocate is part of Speak up the (A).
The task is within the UAP's scope of practice and competence is part of the 5 rights of delegation & supervision as "right task".
demonstrating understanding of pain & suffering includ physiologic models of pain & comfort is an example of knowledge from the KSA's, one of the KSA's from the IOM/QSEN PATIENT-CENTERED CARE COMPETENCY.
in the nursing priority this feature focuses on the need for action but not necessarily for life-threatening situations; safety alerts are essential, though, to ensure optimal patient outcomes Action alert.
this refers not just to physician incidents but to errors caused by all members of the health care team or system that lead to patient injury or death Medical harm.
what are the five rights of the delegation and supervision process. Right TASK; CIRCUMSTANCE; PERSON; COMMUNICATION; SUPERVISION.
This quality improvement (QI) project recommends these targeted solutions to ensure successful communication using the acronym SHARE: standardized critical content, hardwire w/in your system, allow opp. to ask questions, reinforce quality & measure, educate & coach.
the integration of the best current evidence to make decisions about patient care. It considers the patient's preferences & values, & one's own clinical expertise for the delivery of optimal health care is called evidence based practice (EBP).
nurses are expected to use data to monitor the outcomes of care processes & use improvement methods to design and test changes to continuously improve the quality and safety of health care systems in order to meet quality improvement competency.
Educate yourself about your diagnosis, the medical tests you are undergoing, and your treatment plan. is part of the E in Sp(E)ak up.
an indication of clinical decline with in the first 48 hours of code blue is decreased blood pressure, increased heart rate, & a change in mental status.
based on TJC's National Patient Safety Goals Administering medication that is not familiar to the nurse is considered a high-risk issue.
HC providers who intervenes rapidly when needed for those who are beginning to clinically decline rapid response team (RRT)/ (Medical Emergency Team MET).
recognizing personal attitudes about working w/ different ethnic, cultural, & social backgrounds is an example of attitude from the KSA's, one of the KSA's from the IOM/QSEN PATIENT-CENTERED CARE COMPETENCY.
The six core competencies for health care professionals based on research by the Institute of Medicine (IOM) and Quality and Safety Education for Nurses (QSEN) are patient-centered care, teamwork and collaboration, evidence-based practice, quality improvement, informatics, and safety.
when a RN delegates and supervises a nursing task or activity to a UAP the right task is defined as Right Task: The task is within the UAP's scope of practice and competence.
Pay attention to the care you are receiving. Make sure you're getting the right treatments & medications by the right health care professionals. Don't assume anything. is the P in S(p)eak Up
The KSAs stress the importance of learning how to use three important processes specific QI tools, participating in root cause analyses, & impacting changes in care processes.
in the nursing priority this feature emphasizes the need for action for potential or actual life-threatening problems critical rescue.
What is the purpose of the Rapid Response Team (RRT)? Enable the nurse to recognize changes in patient status before an acute emergency.
What type of focused information helps the receiving nurse maintain continuity of care & address any new patient problems that may have occurred (the nurse establish docu of & reporting protocols at facility) Patient Problem, Assessment/Actions, Continuing/Changes, and Evaluation (PACE).
The best source of evidence based practice (EBP) is using research from reliable sources.
The most successful institute of health improvement ( IHI ) initiative was the creation of the rapid response team (RRT) (Medical Emergency Team MET).
reducing surgical complications & preventing pressure ulcers are examples of IHI intervention to prevent patient harm.
Know what medications you take and why you take them. Medication errors are the most common health care errors is the K in speak up.
exploring ethical & legal implications of patient centered care is an example of knowledge from the KSA's, one of the KSA's from the IOM/QSEN PATIENT-CENTERED CARE COMPETENCY.
As a medical-surgical nurse, you will be expected to Identify indicators to monitor quality and effectiveness of health care.
because of the high incidence of patient death & errors during health care, the TJC requires HC providers to create a culture of safety. TJC has published & implemented programs such as publishing national patient safety goals (NPSGs), implemented peer eval accreditation every 3 yrs, set safety goals every yr, & accredit HC org when they meet these goals.
The patient care setting and resources are appropriate for the delegation is part of the 5 rights of delegation and supervision as "The Right Circumstance".
Nursing safety priority critical rescue; Early clinical changes in condition occur in most patients for up to 48 hours before a “Code Blue.” Therefore observe for, document, & communicate early indicators of patient decline, including decreasing blood pressure, increasing heart rate, & changes in mental status.
if you have questions or concerns, and if you don't understand, ask again. It's your body and you have a right to know (S) in speak up.
The concept of the fundamentals of nursing & primary focus of medical-surgical nursing care is to meet the biologic, psychosocial, cultural, & spiritual needs of the adult patient in a mutually trusting, respectful, & caring relationship.
Respect for people is the basis for three essential ethical principles that nurses & other health care professionals should use as a guide for clinical decision making which are autonomy (self determination, mgnt), beneficence, justice/equality (social justice).
HC Errors by physicians, nurses, & other health care professionals resulted in patient deaths, injuries & increased HC costs. As a result of these findings, a number of national and international organizations have implemented new programs & standards to combat this growing problem.
THE IOM/QSEN PATIENT-CENTERED CARE COMPETENCY was developed based on a nurses knowledge, skills, and attitudes (KSAs) needed for patient-centered care.
describing diverse culture, ethnic, & social background that function as sources of patient, family & community values is an example of knowledge, one of the KSA's from the IOM/QSEN PATIENT-CENTERED CARE COMPETENCY.
Use a hospital, clinic, surgery center, HC organization that has undergone a rigorous on-site evaluation against established state-of-the-art quality & safety standards, such as that provided by The Joint Commission is the U in speak up.
The TJC requires care org to focus on priority safety practices many involve nursing care.
Nurses also provide family-centered care, teaching them how to be empowered & have more control over their care is an example of a nurse As an advocate for the patient and family.
Early clinical changes in condition occur in most patients for up to 48 hours before a “Code Blue.” (a nurse or family member usually calls RRT.
The UAP is competent to perform the delegated task or activity is part of the 5 rights of delegation and supervision as "the Right Person'
This organization addresses high risk issues such as drug admin, reducing falls, prevent pressure ulcers, & promotes communication between HC team TJC the joint commission.
Ensuring patient and staff safety requires individual and systematic evaluation and change.
when a nurse observes a decrease in blood pressure, increase in heart rate or a change in mental status they should call the rapid response team (RRT)/ medical emergency team (MET).
facilitating informed consent for care is an example of skills from the KSA's, one of the KSA's from the IOM/QSEN PATIENT-CENTERED CARE COMPETENCY.
What does the Acronym for: Standardize critical content, Hardwire within your system, Allow opportunity to ask questions, Reinforce quality and measurement, educate &coach SHARE.
Produced every year by the TJC this identifies several factors that contribute to error The national patient safety goals (NPSGs).
providing details of patients history to receiver, emphasizing key info about patient & synthesizing info from various sources before passing it on is a solution for standardizing critical content using SHARE.
An electronic documentation system (computer) that is used at the bedside allows 1) Access and evaluate data to monitor quality and effectiveness of health care, 2) Recommend ways to and 3) implement activities to improve care processes.
Participate in all decisions about your treatment. You are the center of the health care team. is the P in speak up.
reducing methicillin resistant staphylococcus aureus (MRSA) infections is an example of IHI intervention to prevent patient harm.
what is the purpose of the rapid response team/ emergency medical team enables the nurse to recognize changes in patient status (decr blood pressure, incr heart rate, change in mental status) before an acute emergency.
respecting patient prefernces for degree of active engagement in care processes is an example of attitude from the KSA's, one of the KSA's from the IOM/QSEN PATIENT-CENTERED CARE COMPETENCY.
The nurse provides a clear and concise explanation of the task or activity, including limits and expectations is part of the 5 rights of delegation and supervision known as " Right Communication".
Speak up demonstrate respect for patients/people in their ability to be care partners. it is the basis for three essential ethical principles that HC & nurses use as a guide for clinical decision making which are self-determination ( Autonomy, self management), beneficence, and justice (social justice/equality).
Respect implies that patients are treated as autonomous individuals capable of making informed decisions about their care.
What report/ published by who identified several factors that contribute to patient death & motivated other national bodies to examine ways they could improve patient safety & quality care To Err is Human: Building a Safer Health Care System, published by institute of medicine (IOM).
A physician who specializes in critical care intensivist (usually part of RRT).
Identify three ways that informatics and technology are used in health care documentation, electronic data access, and health care resource tracking.
Deploying the rapid response team is an IHI intervention to save lives.
recognizing personally held values & beliefs about management of pain & suffering is an example of attitude from the KSA's, one of the KSA's from the IOM/QSEN PATIENT-CENTERED CARE COMPETENCY.
The TJC campaign that provides information to patients and families to increase their empowerment, the framework urges patient and families to _____ and is called __ speakup, S.P.E.A.K. U.P.
The scope of medical-surgical nursing, sometimes called adult health nursing, is to promote health and prevent illness or injury in patients from 18 to older than 100 years of age that is broad based & in a variety of settings.
providing reliable evidence based care for acute myocardial infarction is an IHI intervention to save lives.
what involves using information and technology to communicate, manage knowledge, mitigate error, and support decision-making informatics.
the process of transferring to a competent person the authority to perform a selected nursing task or activity in a selected patient care situation is called delegation.
the KSAs for open communication, mutual respect & shared decision making competency emphasize the importance of communication and team oriented functioning.
define Speak up speak if questions concerns, pay attention, educate, ask for advocate, know what meds you take & why, use accredited facilities, participate in your treatment.
the med/surg nurse recognizes patient/ designee as the source of control & full partner in providing compassionate & coordinated care based on respect for patient's preferences, values, & needs is the definition of patient centered care, (the nurse is competent in patient centered care).
The Joint Commission requires that health care organizations create a _A_ by following the _B_ A) culture of safety B) National Patient Safety Goals (NPSGs).
providing reliable evidence based care for congestive heart failure is an example of IHI intervention to prevent patient harm.
The nurse appropriately monitors, evaluates, intervenes, and provides feedback on the delegation process as needed is part of the five rights of delegation and supervision known as "Right Supervision".
developing standardized forms, tools, & methods (checklists, identifying new & existing technologies to assist in info hand off, stating expectations on how to hand off is an example of being hardwired within your system S(H)ARE.
The emphasis of the KSAs for informatics is documentation, electronic data access, and data utilization.
this team saves lives & decreases the risk for harm by providing care to patients before a respiratory or cardiac arrest occurs Rapid response team (RRT)/Medical emergency team (MET).
assessing the presence & extent of pain & suffering is an example of skills from the KSA's, one of the KSA's from the IOM/QSEN PATIENT-CENTERED CARE COMPETENCY.
The KSAs for competence in patient-centered care focus on communication, compassion, culture, patient education and empowerment, and respect for patients and their families
These Goals require health care organizations to focus on specific priority safety practices, many of which involve nursing care National Patient Safety Goals (NPSGs).
according to ANA COE, a nurse is ethically obligated to protect patient as an advocate within the professional scope of practice When the patient is not capable of self-determination (autonomy).
One of the most important members of the interdisciplinary ID team is the _________, who is typically a nurse or social worker in acute care hospitals case manager (CM)
Communication is an essential process for successful collaboration.
for documenting nursing and interdisciplinary care, the largest application of health care informatics is use of the electronic health record (EHR) (also called electronic patient record [EPR] or electronic medical record [EMR]).
A family practitioner or internist employed by the hospital is called hospitalist (usually part of the RRT).
Every transition of care is potentially risky for patients b/c vital info. needs to be communicated among caregivers & from one HC agency to another to keep patients safe, what quality improvement (QI) is impleented SHARE.
A nurse or family members can place emergency call to RRT based on established agency protocols & policies.
cardiac arrest or patient death is called code blue.
In addition to being able to provide care with skill in techniques & procedures. what must the medical-surgical nurse also be prepared to utilize when caring for the patient? teaching, patient advocacy, spiritual counseling & support, & coordination of care.
The nurse is always accountable for the task or activity that is delegated, therefore delegation requires precise & accurate communication & follow the 5 rights of delegation and supervision.
These goals address high-risk issues such as drug administration, fall reduction, pressure ulcer prevention, and communication among health care team members National Patient Safety Goals (NPSGs).
preventing central line infections or preventing adverse drug events (ADEs) are example of IHI interventions to save lives.
Another major purpose of informatics is for retrieval of data for the evidence-based practice process usually using creditable & reliable internet resources.
. to avoid code blue and ensure patient care, Nurses need to observe for, document, & communicate early indicators of patient decline, including decreasing blood pressure, increasing heart rate, and changes in mental status.
the 2nd ethical principle used as a guide in decision making emphasizes the importance of preventing harm & ensuring the patient's well-being is called beneficence.
providing patient centered care with sensitivity & respect for diversity of human experience is an example of skills from the KSA's, one of the KSA's from the IOM/QSEN PATIENT-CENTERED CARE COMPETENCY.
a formal method of communication (hand off communication) between two or more members of the health care team. SBAR.
The RRT does not replace the Code Team who responds to patient arrests.
what are the 6 core competencies that HC professionals need to provide safe, quality health care patient-centered care, teamwork and collaboration, evidence-based practice, quality improvement, informatics, and safety.
when the blood flow is reduces and there is a decrease in oxygen resulting in the failure to nourish the tissues at the capillary level & med team has to inject fluid to supply oxygen it is called oxygenation & tissue perfusion.
planning, implementing, & evaluating patient care together using an interdisciplinary (ID) plan of care is called collaboration.
the best practice when using information from electronic sources, such as websites or e-mail, in retrieving data for the evidence-based practice process? Evaluating the information for credibility and reliability before putting it into use.
the third principle to making ethical decisions , refers to equality; that is, all patients should be treated equally & fairly (if patient can't afford they should still receive the same care) is called justice/equality, social justice.
using critical thinking, sharing & receiving info when discussing patient care as a pit crew team, receivers expect all key info. , scrutinize & question data & exchange contact info w/ sender is part of SH(A)RE; allowing the opportunity to ask questions.
preventing surgical site infections(SSIs) and ventilator associated pneumonia (VAP) is an IHI intervention to save lives.
examining how safety, quality & cost effectiveness of HC can be improved thru active involvement of patient and families is an example of knowledge from the KSA's, one of the KSA's from the IOM/QSEN PATIENT-CENTERED CARE COMPETENCY.
what technology allows any person or object to be tracked electronically. For example, patients wear electronic identification wristbands radio frequency identification (RFID).
The purpose of the case management process is to provide quality and cost-effective services and resources to achieve positive patient outcomes.
Due to the IOM report, The Joint Commission (TJC), requires that health care organizations create a culture of safety & encourage patients & families to become safety partners in protecting patients from harm.
Explain the importance of communication when collaborating with the interdisciplinary team It allows a nurse to function as coordinators of care by communicating and collaborating with members of the health care team.
Scheduling home visits after discharge and monitoring patient progress, exemplifies the goal of case management in an acute care setting.
In collaboration with the nurse, who coordinates inpatient & community-based care before discharge from a hospital or other facility the case manager.
The RRT members are usually comprised of ICU nurse, intensivist, hospitalist, acute care nurse practitioner, &/or medical resident.
guidance or direction, evaluation, & follow-up by the nurse to ensure that the task or activity is performed appropriately is known as proper supervision based on the 5 rights of delegation & supervision.
The National Council of State Boards of Nursing (NCSBN) identified nine key areas where nursing practice should be improved Med admin, communicating data & assessments; Attentiveness/surveillance of patients, Clinical reasoning or judgment; Prevention of errors; Intervention timely/appropriate; Interpretation orders; responsibility & advocacy; Mandatory reporting.
Getting board of HC organizations to support measures to promote safe patient practices is an example of IHI intervention to prevent patient harm.
using a formal method of information hand off , National Patient Safety Goal mandated that nurses communicate continuing patient care needs such as pain management or respiratory support, to post-discharge caregivers.
demonstrating leadership in handing off patient info., holding staff accountable, monitoring compliance w/ use of standard forms & using data to determine a systematic approach for improvement is part of SHA(R)E: reinforcing quality & measurement.
Which type of evidence is rated highest on a Level of Evidence scale? Systematic review or meta-analysis of all randomized controlled trials.
Outcome data demonstrate that the RRT approach to emergency care reduces medical complications and decreases the number of cardiac and respiratory arrests.
each state designates which task can be delegated to nursing team members; patient care responsibilities may be assigned by an RN or nursing leader to unlicensed assistive personnel (UAP), patient care technicians (PCTs), patient care assistants (PCAs), another RN or to a licensed practical or vocational nurse (LPN/LVN).
engaging in patient or surrogates in active partnership that promotes health, safety, & well being & self care is an example of skills from the KSA's, one of the KSA's from the IOM/QSEN PATIENT-CENTERED CARE COMPETENCY.
to achieve quality patient care & provide patient- & family-centered care, the nurse “functions effectively within nursing & inter-professional teams, fostering open communication, mutual respect, and shared decision-making.
Requesting another staff member to help turn a patient, Admin med as prescribed, Make referral to CM to assist w/discharge planning, & Ensuring clear comm w/ HC providers demonstrates a collaborative nursing function.
Nursing Safety Priority are features that delineate safety based on patient need, what are the nursing safety priority critical rescue, action alert, & drug alert.
what report did the IOM publish suggesting ways to improve patient safety and quality care IOM Report Health Professions Education: A Bridge to Quality.
IOM Report Health Professions Education: A Bridge to Quality identified 5 broad core competencies for HC to ensure patient safety & quality care that are interrelated which are Provide patient-centered care; Collaborate with the interdisciplinary HC team; Implement evidence-based practice; Use quality improvement in patient care; Use informatics in patient care.
teaching staff about proper hand off, standardizing training on how to conduct a hand off, providing feedback during, & making hand off of info organized is a part of SHAR(E); educating and coaching.
Which is the best way for the nurse to assess the patient's learning after teaching? Ask the patient to repeat the information back.
Overload of information, Poor communication & Failure to follow accepted facility practices are all factors that are likely causes of medical errors.
The SBAR process includes these four steps, name them Situation (Describe what's happening for this comm; Background: ( relevant info related to); Assessment: (analysis of prob/need based on data); Recommendation ( what is needed & desired outcome).
I-SBAR and I-SBAR-R stand for the same protocol as SBAR except I stand for identify yourself, & R stands for the response that the receiver provides based on the information given.
Patient Problem, Assessment/Actions, Continuing/Changes, and Evaluation stands for PACE.
in the nursing priority this feature specifies actions needed to ensure safety related to drug administration, monitoring, or related patient and family education called drug alert.
respecting and encouraging indiv expression of patient values, preferences, & expressed needs is an example of attitude from the KSA's, one of the KSA's from the IOM/QSEN PATIENT-CENTERED CARE COMPETENCY.
Describe the SBAR procedure for successful communication in health care agencies SBAR is a procedure /protocol (like PACE & SHARE) used for successful communication between caregivers & between HC agencies.
Assessing the need for glasses & hearing aids as appropriate, & assessing for previous knowledge & cultural values before beginning teaching is a best practiced when teaching older adults.
CENTER FOR TRANSFORMING HEALTH CARE TARGETED SOLUTIONS TO ENHANCE SUCCESSFUL HAND-OFF COMMUNICATION produced what is known as SHARE.
Created by: larue10510
 

 



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