Foundations: Fundamentals of Nursing, Key Points - Chapter 3, 20, 24, and 25
Principles of public health nursing practice focus on
assisting individuals and communities with achieving a healthy living environment
Essential public health functions include
community assessment, policy development, and access to resources
When population-based health care services are effective,
there is a greater likelihood that the higher levels of services will contribute efficiently to health improvement of the population.
The community health nurse
cares for the community as a whole and assesses the individual or family within the context of the community.
Successful community health nursing practice
involves building relationships with the community and being responsive to changes within the community.
The community-based nurse’s competence is
based on decision making at the level of the individual patient.
The special needs of vulnerable populations are
a challenge that nurses face in caring for these patients’ increasingly complex acute and chronic health conditions.
A community-based nurse is
competent as a caregiver, collaborator, educator, counselor, change agent, patient advocate, case manager, and epidemiologist.
Patients are more likely to accept a change if
it is more advantageous, compatible, realistic, and easy to adopt.
Evaluation is a step of the nursing process that includes two components:
an examination of a condition or situation and a judgment as to whether change has occurred.
During evaluation apply critical thinking to
make clinical decisions and redirect nursing care to best meet patient needs.
Positive evaluations occur
when you meet desired outcomes and they lead you to conclude that your interventions were effective.
Criterion-based standards for evaluation are
the physiological, emotional, and behavioral responses that are a patient’s goals and expected outcomes.
Evaluative measures are
assessment skills or techniques that you use to collect data for determining if outcomes were met.
It sometimes becomes necessary to collect evaluative measures over time to
determine if a pattern of change exists
When interpreting findings, you
compare the patient’s behavioral responses and physiological signs and symptoms that you expect to see with those actually seen from your evaluation and judge the degree of agreement.
Documentation of evaluative findings
allows all members of the health care team to know whether or not a patient is progressing.
A patient’s nursing diagnoses, priorities, and interventions sometimes
change as a result of evaluation.
Evaluation examines two factors:
the appropriateness of the interventions selected and the correct application of the intervention.
a powerful therapeutic tool and an essential nursing skill that influences others and achieves positive health outcomes.
Effective interdisciplinary communication is essential to
provide safe transitions and care.
Effective communication is critical in
promoting collaboration and teamwork providing patient-centered care.
Critical thinking facilitates communication through
creative inquiry, focused self-awareness and awareness of others, purposeful analysis, and control of perceptual biases.
Communication is most effective when the receiver and sender
accurately perceive the meaning of one another’s messages.
The sender’s and receiver’s physical and developmental status, perceptions, values, emotions, knowledge, sociocultural background, roles, and environment all influence
Effective verbal communication requires
appropriate intonation, clear and concise phrasing, proper pacing of statements, and proper timing and relevance of a message.
Effective nonverbal communication complements and strengthens
the message conveyed by verbal communication.
Nurses use intrapersonal, interpersonal, transpersonal, small-group, and public interaction
to achieve positive change and health goals.
Nurses strengthen helping relationships by
establishing trust, empathy, autonomy, confidentiality, and professional competence.
Effective communication techniques are facilitative and tend to encourage
the other person openly expressing ideas, feelings, or concerns.
Ineffective communication techniques are
inhibiting and tend to block the other person’s willingness to openly express ideas, feelings, or concerns.
Blend social and informational interactions to help your patients explore feelings and manage health issues.
with therapeutic communication techniques
Older adults with sensory, motor, or cognitive impairments require the adaptation of
communication techniques to compensate for their loss of function and special needs.
Patients with impaired verbal communication require
special consideration and alterations in communication techniques to facilitate sending, receiving, and interpreting messages.
Desired outcomes for patients with impaired verbal communication include
increased satisfaction with interpersonal interactions, the ability to send and receive clear messages, and attention to and accurate interpretation of verbal and nonverbal cues.
The nurse ensures that patients, families, and communities receive information needed to
promote, restore, and maintain optimal health.
Teaching is most effective when it is
responsive to a learner’s needs.
Teaching is a form of interpersonal communication, with the teacher and learner
actively involved in a process that increases the learner’s knowledge and skills.
The ability to learn depends on a person’s
physical and cognitive attributes.
The ability to attend to the learning process depends on physical
comfort and anxiety levels and the presence of environmental distraction.
A person’s health beliefs influence the willingness to
gain knowledge and skills necessary to maintain health.
Use of a theory (e.g., social learning theory) or theoretical concepts (e.g., self-efficacy)
Time teaching so it occurs when
a patient is ready to learn.
Patients of different age-groups require
different teaching strategies because of developmental capabilities.
Involve patients actively in
all aspects of teaching plans.
Nurses use learning objectives to
set learning priorities.
A combination of teaching methods improves the learner’s
attentiveness and involvement.
A teacher is more effective when presenting information that
builds on a learner’s existing knowledge.
Effective teachers use
Older adults learn most effectively when
information is paced slowly and presented in small amounts.
Evaluate a patient’s learning by
observing performance of expected learning behaviors under desired conditions.
Effective documentation describes the entire process of
patient education, promotes continuity of care, and demonstrates that educational standards have been met.