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Definitions of health ✔✔-a state of complete physical, mental, and social well-being, not merely the absence of disease or infirmity (WHO — world health org.)
- a state of being that people define in relation to their own values, personality, and lifestyle
Marlow's Hierarchy of Needs: order from bottom to top ✔✔-Bottom to top:
O2, H2O, food, shelter, body temp, elimination
physical safety & psychological safety
love and belonging needs
self-esteem
self-actualization
What is the most important level of Maslow's Hierarchy of Needs? ✔✔-The bottom (physiological needs) are major factors in determining level of health. Most important needs of people. Must be addressed first.
- However, each patient has different needs. You have to understand the relationships of different needs and factors to determine priorities for each pt.
What is the Holistic Health Model? ✔✔A model that assesses the whole person because it views the mind, body, and spirit as interdependent and functioning as a whole within the environment.
Each aspect (emotional, spiritual, cultural, and physical) is important for health and wellness.
Examples of Holistic Therapies ✔✔reminiscence, meditation, music therapy, guided imagery
(these therapies can be used in ALL stages of health and illness)
Internal variables that influence health, health beliefs, and practices ✔✔developmental stage, intellectual background, perception of functioning, emotional factors, spiritual factors
Emotional Factors ✔✔(internal variable)
a pts degree of stress, depression, or fear. how pt handles stress influences reaction to illness.
(calmer people may have little emotional response to illness; stressed individual may not be able to cope, will overreact, and may deny symptoms and not follow through with treatment)
Spiritual Factors ✔✔(internal variable)
spiritual factors can be reflected in how a person lives his/her life including values and beliefs, relationships formed, and ability to find hope/meaning in life.
(important to integrate a pts spiritual belief into their nursing care)
External variables that influence health, health beliefs and practices ✔✔family role and practices, social determinants of health,
Family Role and Practices ✔✔(external variable)
the roles and organization of family influence how each family member defines health and illness and values health practices
in other words, family's beliefs influence pts as that is what they're used to seeing/living
Social Determinants of health ✔✔(external variable)
where a person lives, the quality of environment, income, education level, and relationships with others impact pts health
conditions in which people are born, grow, live, work and age
five categories: economic stability, education, health and health care, social and community context, and neighborhood and built environment
Health promotion ✔✔helps individuals maintain or enhance their present health
(routine exercise, good nutrition, adequate sleep)
Health education ✔✔helps people develop a greater understanding of their health and how to better manage their health risks
(ex. promoting hearing protection in occupational settings and providing education to reduce cardiac disease risk factors)
Secondary prevention ✔✔focuses on preventing the spread of disease, illness or infection once it occurs
activities are directed at diagnosis and prompt intervention — reducing severity and enabling pt to return to normal level of health asap
(ex. screenings, treating early disease to limit disability, delaying consequences of advanced disease)
Tertiary prevention ✔✔occurs when a defect or disability is permanent and irreversible
involves minimizing the effects of long-term disease or disability by interventions directed at preventing complications and deterioration
activities directed at rehabilitation rather than diagnosis and treatment — care at this level helps pt achieve as high a level of functioning as possible
Risk factor ✔✔any attribute, quality, environmental situation, or trait that increases the vulnerability of an individual or group to an illness or accident
(ex. risk factors for falls: impaired gait, reduced vision, lower extremity weakness)
***risk factors DO NOT cause diseases/accidents instead they increase the chances of them happening
Nonmodifiable risk factors ✔✔can not be changed
age, gender, genetics, and family history
(secondary prevention strategies used for these)
Modifiable risk factors ✔✔can be changed: lifestyle practices and behaviors
Preparation stage ✔✔making small changes in preparation for a change in the next month
(may have tried to make changes in the past but was unsuccessful. pt believes that advantages outweigh disadvantages of behavior change)
Action stage ✔✔actively engaged in strategies to change behavior; lasts up to 6 months
(committed to change. previous habits may become barriers to change)
Maintenance stage ✔✔sustained change over time; begins 6 months after action has started and continues indefinitely
(changes integrated into pts lifestyle and behaviors adopted to prevent relapse)
illness ✔✔a state in which a person's physical, emotional, intellectual, social, developmental, or spiritual functioning is diminished or impaired
a person can feel ill in the presence or absence of disease (many pts have illness but feel healthy)
acute illness ✔✔usually reversible and has short duration.
symptoms appear abruptly, are intense and subside after a relatively short period
more likely to seek healthcare
chronic illness ✔✔usually lasts more than 6 months, is irreversible, and affects functioning in one or more systems
pts often fluctuate between maximal functioning and serious health relapses that may be life threatening
may become less actively involved in their care, experience greater frustration, and have difficulty adhering to their treatment plan
illness behavior ✔✔people who are ill often adopt cognitive, affective, and behavioral reactions that are influenced by sociocultural and psychological factors
team nursing ✔✔care provided by a group led by an RN
the team includes other RNs, practical nurses, and assistive personnel (APs)
primary nursing ✔✔one RN assumes the responsibility for a caseload of patients from admission to discharge
the same nurse cares for the same patients throughout hospitalization
when that nurse isn't scheduled directions (plan of care) are left for other RNs to follow
patient- and family-centered care ✔✔promotes mutual partnerships among patient, family, and healthcare team to plan, implement, and evaluate nursing and health
4 core concepts of patient- and family-centered care ✔✔dignity and respect
information sharing
participation
collaboration
case management ✔✔coordinates and links health care services across all levels of care for patients and families while streamlining costs and maintaining quality
focused on achieving patient outcomes within effective time frames and with available resources
what does a nurse executive do? ✔✔a nurse executive supports nurse managers by advocating a nursing governance structure that incorporates policies and procedures for decision making needed to achieve organizational goals
what does a nurse manager do? ✔✔a nurse manager directs and supports a group of staff in applying an organizations nursing philosophy.
shared governance ✔✔typical decentralized structure used within healthcare organizations today
staff involvement through: ✔✔-establishing nursing practice through problem-solving committees or professional shared governance councils
-interprofessional collaboration among nurses and health care providers
-interprofessional rounding
-staff communication
-staff education
clinical care coordination ✔✔you need to able to make clinical decisions, set priorities, delegate safely, gain organizational skills, use resources, manage time and evaluate your pts outcomes
clinical decisions ✔✔applying the nursing process to form an accurate plan of care
(assessment, nursing diagnosis, planning, implementation, evaluation)
priority setting ✔✔set priorities by deciding which patient needs or problems need attention first
(use maslows)
organizational skills ✔✔plan of care requires effective and efficient use of time
effective use of time means doing the right things, whereas efficient use of time means doing things right
use resources ✔✔appropriate use of resources (members of health care team).
ask for help! bounce ideas off of!
time management ✔✔learn how, where and when to use your time. remain goal oriented and use time wisely
be organized, prepared and manage priorities
evaluation ✔✔ongoing process
colonization ✔✔is the presence and growth of microorganisms within a host but without tissue invasion or damage
what are Health care-associated infections (HAIs)? ✔✔result from the delivery of health services in a health care agency
occur as a result of invasive procedures, antibiotic administration, the presence of MDROs, and breaks in infection prevention and control activities
where do HAIs typically occur? ✔✔major sites for HAIs — surgical and traumatic wounds, urinary and respiratory tracts, and the bloodstream
who is most susceptible to HAIs? ✔✔patients who have multiple illnesses, are older adults, are poorly nourished, may have a compromised immune system
what factors influence infection prevention and control? ✔✔age — babies are born with weak immune system, immune system matured with age, weakens again in older adults
sex — estrogens promote immune responses during infections and after vaccination. estrogens also increase risk for autoimmune diseases
nutritional status — low protein reduces body defenses against infection and wound repair
stress — stress can lower immune system
disease process — pts with diseases of immune system are at high risk for infection (leukemia, AIDS, lymphoma, aplastic anemia)
what are examples of health promotion against infection? ✔✔nutrition — vary depending on pt age and condition but proper diet helps the immune system function
(teach pt importance of proper diet in maintaining immunity and preventing infection)
hygiene — personal hygiene measures reduce microorganisms on the skin and maintain the integrity of the mucous membranes such as mouth and vagina
(pt and family caregivers need to understand technique for cleansing skin and how to avoid spread of microorganisms in body secretions and excretions)
