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Chapters 1-4 Chapters 1-4 Chapters 1-4
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2 main professional organization that support critical care practice - ✔AACN SCCM Which best supports critical care NURSES? - ✔AACN mission of AACN - ✔to drive excellence in patient care through knowledge and influence vision of AACN - ✔creating a healthcare system driven by needs of patients and families which nurses make their optimal contributions values of AACN - ✔accountability collaboration leadership innovation Synergy Model - ✔shifted assessment from body systems focus to a nursing competencies framework (there's 8 of them). It is used broadly in nursing practice, not just critical care. The central idea is that a patient's needs drive the nurse competencies required for patient care. When these align, the characteristics of the nurse and patient match, creating synergy and enabling optimal outcomes how does the synergy model influence AACN certifications - ✔1. It develops the competencies they must meet
Quality and Safety Education for Nurses Project - ✔i. sponsored by AACN: provides road map for integrating quality and safety principles into prelicensure nursing education. Defines 6 core competencies the provide a foundation for quality care: Patient Centered Care, Teamwork and Collaboration, Evidence-based practice, Quality Improvement, Informatics, and Safety Joint Commission - ✔identified National Patient Safety Goals to be addressed in hospitals, long term care facilities, and other agencies Institute for Healthcare Improvement (IHI) - ✔introduced bundles of care to reduce healthcare associated infections bundle of care - ✔3-5 evidence-based best practices that are done as a whole to improve outcomes, and research is done to evaluate effectiveness Barriers to effective handoff communication - ✔-Physical setting (noise, lack of privacy, interruptions) -Social setting (organizational hierarchy, status) -Language -Communication medium (limits of telephone, email, paper, computerized records vs. face to face) when is communication at highest risk to be broken down? - ✔shift handoff standardized measures implemented to help prevent communication breakdown at shift change - ✔-SBAR -QSEN Exemplar box -Checklists -Training all personnel in effective communication methods What type of things contribute to sensory overload/deprivation? - ✔-Light and noise -Phlebotomy procedures -Loss of privacy -Lack of nonclinical physical contact -Pain which age-related demographic is at highest risk for negative ICU outcomes? - ✔older adults how can nurses best support family members of patients and assist them in coping?
advanced directive - ✔witnessed written document or oral statement in which instructions are given by a person to express desires related to healthcare decisions. May designate a healthcare surrogate, a living will, or anatomical gift living will - ✔a type of advanced directive; a witnessed written document or oral statement voluntarily executed by a person that expresses the persons instructions regarding life-prolonging procedures proxy - ✔a competent adult who has not been expressly designated to make healthcare decisions for an incapacitated person but is authorized by state statute to make healthcare decisions for the person surrogate - ✔a competent adult designated by the person to make healthcare decisions should that person become incapacitated terminal condition - ✔there is no reasonable medical probability of recovery and can be expected to cause death without treatment persistent vegetative state - ✔a permanent irreversible unconsciousness condition that demonstrates an absence of voluntary action or cognitive behavior or an inability to communicate or interact purposefully with the environment brain death - ✔complete and irreversible cessation of brain function DNR - ✔medical order that prohibits the use of cardiopulmonary resuscitation and emergency cardiac care to reverse signs of clinical death. May or may not be specified in advanced directive Allow Natural Death - ✔an alternate term with less negative connotations but essentially means DNR medical futility - ✔the alleged pointlessness or ineffectiveness of administering particular treatments interventions cannot accomplish the intended physiological goal palliative care - ✔provision of care interventions designed to relieve symptoms of illness or injury that negatively affect the quality of life hospice - ✔reserved for terminally ill, usually inpatient setting, can include withdrawal of vent support and other therapies what distressing symptoms does palliative care address? - ✔-pain -anxiety -hunger -thirst -dyspnea -diarrhea -nausea -confusion -agitation
-disturbance in sleep how is withdrawal of care different from euthanesia - ✔Euthanasia is painless killing aka assisted suicide and it is illegal in the US.