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2025 PMHNP - role and health policy, research,
health promotion with 100% Verified Solutions
Team Leadership Model - ✔✔input, process, output Quality improvement Nursing Leadership - ✔✔Take on roles beyond/in addition to direct patient care As a nurse, consider getting involved in issues that impact the social determinants of health such as: urban development, housing, food access, education policy Due to emphasis on relationships, caring, nursing profession uniquely equipped to lead reduction of health disparities Identify needed change & inspire others to a new vision Bring attention to social determinants of health: Health promotion Targeted interventions, education, advocacy Reflective Practice - ✔✔critical thinking to problem solving and enhancing clinical reasoning and desicion making; links theory to practice NP role - ✔✔conflict resolution negotiation mediation arbitration - 3rd party to review the evidence professional civility - respect towards one another Research Quality improvement Leadership
Reflective practice Integration of care Collaboration Coordination of care Family assessments Discharge planning Research - PICO method - ✔✔P - population/patient I - intervention C - comparison O - outcome dissemination - ✔✔the act of spreading something, especially information, widely; circulation internal validity - ✔✔independant variable causing change in the dependant variable EX: tx (independant variable) led to outcome (dependent variable) external validity - ✔✔sample of population in the research that can be generalized GENERALIZATION descriptive statistics - ✔✔DESCRIPTIVE SAMPLE numerical data used to measure and describe characteristics of groups. Includes measures of central tendency and measures of variation. inferential statistics - ✔✔TESTING CONCLUSIONS numerical methods used to determine whether research data support a hypothesis or whether results were due to chance
PDSA cycle - ✔✔Plan, Do, Study, Act ANA position statement - ✔✔Assisting in suicide and participating in active euthanasia are in violation of the Code for Nurses holds people accountabel for behaviors and investigates errors health care system - ✔✔All of the activities aimed at promoting, restoring, or maintaining health National Committee for Quality Assurance (NCQA) - ✔✔non-profit organization in the United States that works to improve health care quality through the administration of evidence-based standards, measures, programs, and accreditation. The private, nonprofit organization operates on a formula of measure, analyze, and improve. And it aims to build consensus across the industry by working with policymakers, employers, doctors, and patients, as well as health plans. Affortable Care Act - ✔✔practices reorganized to provide integrated care client centered evidenced based coordinated quality care that moving forward patient centered care model (PCC) - ✔✔welcoming environment respect for clients' client empowerment sociocultural competence coordination and integration of care comfort and support access and navigation skills community outreach
HEALTH CARE, HOME - ✔✔Nursing, medication, nutritional, hygienic or other personal services provided to frail or invalid persons. Usually for short time periods; however, some forms of care can require daily visits for extended periods. Coordinated by hospitals, medical group practices, or Area Agencies on Aging.
- team base care
- builds community support
- car for people with multiple chronic health conditions conflict of interest - ✔✔a situation in which an action by a company or individual results in an unfair benefit. rights of clients - ✔✔right to refuse treatment, right to privacy, right to diagnosis, right to explanation of treatment least restrictive tx consent for tx and withdraw of that consent Health Policy Development - ✔✔Complex, dynamic process; occurs in various ways Enactment of legislation and accompanying rules and regulations that carry the weight of law Administrative decisions made by various governmental agencies Judicial decisions that interpret the law 4 components:
- process
- policy reform
- policy environment
- policy makers Branches of law - ✔✔criminal law and civil law executive legislative judicial
- Other accidents
- homicide
- malignancy
- CV or congenital d/o Mortality in age groups: young adults - ✔✔1. MVA
- homicide
- suicide
- injuries
- heart d/o
- AIDs Mortality in age groups: middle age - ✔✔1. Heart d/o
- accidents
- lung cancer
- CVA
- breast or colorectal CA
- COPD Mortality in age groups: elderly - ✔✔1. Heart d/o
- CVA
- COPD
- PNA
- Lung or colorectal CA primary prevention - ✔✔Actions that change overall background conditions to prevent some unwanted event or circumstance, such as injury, disease, or abuse. Prior to onset EDU
Immunizations secondary prevention - ✔✔Efforts to limit the effects of an injury or illness that you cannot completely prevent. Identification and tx existing problems
- Exams and screening tests 1800 # tertiary prevention - ✔✔actions taken to contain damage once a disease or disability has progressed beyond its early stages Rehab or restoration of health Therapeutic communication - ✔✔Verbal and nonverbal communication techniques that encourage patients to express their feelings and to achieve a positive relationship.
- non-judgemental mutual trust professional boundaries confidentiality cultural competency Listen more "Tell me" Focus on feelings Safety first establish trust show empathy, acknowledge feelings advance directives - ✔✔A legal document designed to indicate a person's wishes regarding care in case of a terminal illness or during the dying process
the patient safety and quality improvement act (PSQIA) - ✔✔voluntary reporting to enhance public safety concerns and health care quality issues evaluate medical errors the agency for healthcare research and quality (AHRQ) within Patient safety organizations (PSOs) - ✔✔external experts established by patient safety act to collect and analyze patient safety information duty to warn and protect - ✔✔Clinicians duty to warn of imminent harm to a duty to protect (Tarasoff rule) danger to self or others Defamation - ✔✔Act of harming or ruining another's reputation Info shared w/o consent Not liable if info is consented to share and if it is liable invasion of privacy - ✔✔revealing personal information about an individual without his or her consent Public disclosure of private facts to improper sources PERLS OF HEALTH CARE DELIVERY - ✔✔1. always start from local level then proceed into wider range (hospital, community, region, state, national)
- Always rule out medical conditions FIRST, then psychosocial
- Evaluation of teaching is returned demonstration - Show me; Tell me what you understand based on what I just said"
- Assess for injuries, stabilize, assess capability of the current facility, transfer
- psychoeducation when appropriate
- most accurate date from the pt or from observation; causion taken w/family interpretation Healthy People 2020 - ✔✔Attain high-quality, longer lives free of preventable disease, disability, injury, and premature death.
Achieve health equity, eliminate disparities, and improve the health of all groups. Create social and physical environments that promote good health for all. Promote quality of life, healthy development, and healthy behaviors across all life stages. Healthy People 2020 goal - ✔✔Achieve health equity, eliminate disparities, and improve the health of all groups Quality and healthy life Eliminate disparities "reporting" - ✔✔-dangerous weapon
- STIs- gon, chlam, syph +HIV and TB
- animal bites
- child or elder abuse - suspected or actual
- domestic violence depends on state collaborative care model - ✔✔american nurses association's nursing's social policy statement 2010 "true partnership and collaboration" Medicare - ✔✔Plan A - hospitals, skilled nursing facilities, home health, hospice B - outpatient, lab, diagnostics, PT/OT, medical equipment, some home health C - medicare advantage - all service through one provider (HMO or PPO) D - drugs Medicaid - ✔✔A federal and state assistance program that pays for health care services for people who cannot afford them - low income families case management nursing - ✔✔Growing field in nursing developed as a way of managing health care costs and patient length of stay; Involves systematic collaboration with patients, their significant others, and their health care providers to coordinate high-quality health care services in a cost effective manner with positive patient outcomes
ANA Standards of Practice - ✔✔Assessment Diagnosis Outcomes identification Planning Implementation Evaluation Standard of practice and professional performance State Practice Act - ✔✔Licensure of the RN Delineate what we can and cannot do Prescriptive authority Standard of edu scope of practice specific practice requirement types & requirements of titles & licenses, violation & disciplinary action rules Prescriptive authority - ✔✔legal authority granted to advanced practice nurses to prescribe medication State Practice Acts dictate the level of prescriptive authority allowed Credentialing - ✔✔general term that refers to ways in which professional competence is maintained
- safe healthcare to qualified individuals
- complaince w/federal and state laws for advance practice nursing
- acknowledges scope of practice for NPs
- mandates accountability
- enforces professional standards
Licensure - ✔✔to be given a license to practice nursing in a state or province after successfully meeting requirements Certification - ✔✔A process in which a person, an institution, or a program is evaluated and recognized as meeting certain predetermined standards to provide safe and ethical care. Credentialing and Privileging - ✔✔Process by which a nurse practitioner is granted permission to practice in an inpatient setting Credentialing by the hospital with hospital credentialing committee Patient Medical Abandonment - ✔✔* When caregiver-patient relationship is terminated w/o making reasonable arrangements
- Determination may depend on the following factors
- whether the practitioner accepted the pt assignment
- whether the practitioner provided reasonable notice before termination
- whether reasonable arrangements could have been made to continue pt care *In most cases, the following do not constitute pt abandonment
- NP refuses to accept pt assignment when the NP has given reasonable notice to the proper authority that the NP lacks competence to carry out the assignment
- An NP refuses an assignment of a double shift/additional hours beyond the posted work schedule (can be arguable) Risk Management - ✔✔using strategies to reduce the amount of risk (the degree of likelihood that a person will become ill upon exposure to a toxin or pathogen).
- Reduce risks: organizational goals program's scope, components, & methods responsibility for implementation & enforcement demonstration of commitment by the board Guarantee of confidentiality & immunity if sensative information has been shared and evaluated
Program-centered Administrative - create action plan that can be implemented by consultant or consultees Consultee-centered Administrative - improve problem-solving skills regarding organizational problems Ethical Principles Nursing - ✔✔study of moral rules & standards governing the conduct of individuals Nursing ethics 2005 established by ANA code of Ethics Nursing ethical principles - ✔✔nonmaleficence - duty to avoid harm utilitarianism - the right act is the one that produces the greatest good for the greatest number beneficence - the duty to prevent harm and promote good justice - duty to be fair fidelity - duty to be faithful veracity - duty to be truthful autonomy - duty to respect an individual's thoughts & actions Nonmaleficence - ✔✔do no harm Utilitarianism - ✔✔the doctrine that actions are right if they are useful or for the benefit of a majority. fidelity - ✔✔faithfulness justice - ✔✔fairness veracity - ✔✔truthfulness autonomy - ✔✔duty to respect an individual's thoughts & actions
The role of the NP - ✔✔Clinician Consultant/collaborator Educator Researcher evidence-based practice - ✔✔nursing care provided that is supported by sound scientific rationale Evidence-Clinical Experience-Patient Preferences critical thinking - ✔✔acguisition of knowledge with attitude of deliberate inquiry & self-awareness w/o assumptions Steps in the Research Process - ✔✔1. Identify the research question
- Conduct a review of the literature
- Formulate hypothesis
- Select a research design
- Identify population of study
- Identify methods of data collection
- Design the study
- Conduct the study
- Analyze data
- Interpret the results
- Communicate the findings PICOT research questions - ✔✔helps summarize research questions that explore the effects of a predictor therapy & intervention format of questions yields the most relevant information P - population; those who recuit survey I - intervention; tx that is provided to experimental group
confidence interval - ✔✔a range that predicts the probability of specific parameter being assessed For ex: parameter 2.8 - 3.2 - nausau in 95% of CA pts standard deviation - ✔✔average amount of the deviation from the mean correlation coefficient - ✔✔a statistical index or the measure of interdependance of 2 random variables that ranges from - 1 to +
- 1 - perfect negative correlation 0 - absence correlation +1 - perfect positive correlation Reliability - ✔✔consistency of measurement
- estimates repeatability of a measurement
- measure considered reliable when person's score on the same test given twice is similar Ways to test reliability - ✔✔test/re-test Internal consistency (3 questions - sample group; measuring instrument) Crohbach's alpha - more than .70; correlation coefficient must be closure to 1 Validity - ✔✔the extent to which a test measures or predicts what it is supposed to HUMAN SUBJECT TRAINING - ✔✔mandated training for researchers based on Belmont Report 1979 liability - ✔✔legal responsibility by NP Negligence - ✔✔careless neglect, often resulting in injury
Malpractice - ✔✔Failure by a health professional to meet accepted standards to render services, degree of care, diligence, or precausion to prevent injury medical malpractice - ✔✔professional negligence of physicians or providers
- dx
- tx
- meds
- pt assessment
- monitoring Malpractice Insurance - ✔✔only within scope of practice Assault - ✔✔threat or attempt to commit battery attacker must be aware and competent capable of caring an attack EX: shaking a fist into direction of a person Battery - ✔✔victim is touched touching that results in bodily injury or offensive touching EX: battery to unconsious person involuntary commitment - ✔✔A civil proceeding in which people are hospitalized in psychiatric facilities against their will. due to developmental disabilities, substance abuse, mental illness danger to self or others Use of restraints - ✔✔to prevent self harm or harm to others
