front 1 What is informed consent | back 1 A legal process by which a client provides written permission for a procedure or treatment to be performed. Consent is considered to be informed when the client has been provided with and understands the treatment/procedure |
front 2 What the client should understand/be explained | back 2 Reason the treatment or procedure is needed How the treatment or procedure will benefit the client Risks involved if the client chooses to receive the treatment or procedure Other options to treat the problem, including the option of not treating the problem Risk involved if the client chooses no treatment |
front 3 The nurse's role in the informed consent process | back 3 Witness the client's signature on the informed consent form and ensure that informed consent has been appropriately obtained Seek language assistance services if the client does not speak and understand the language used by the provider |
front 4 Informed consent Guidelines | back 4 Consent is required for all care provided in a health car facility The client provides implied consent when they comply with the instruction provided by the nurse |
front 5 Kind of procedure that consent is needed | back 5 For invasive procedure or surgery (provided written consent) |
front 6 Who else can give informed consent | back 6 State laws regulate who can give informed consent. Laws vary regarding age limitations and emergencies. The nurse must verify that consent is informed and witness the client sign the consent form |
front 7 Signing an informed consent | back 7 Must be signed by a competent adult Emancipated minors (minors who are independent from their parents (a married minor)can provided informed consent for themselves) Must be able to understand and able to fully communicate in return with the health care professional |
front 8 Individuals authorized to grant consent for another person | back 8 Parent of a minor Legal guardian Court-specified representative Client's health care surrogate(individual who has the client's durable power of attorney for healthcare/heath care proxy Spouse or closet available relative (state laws vary) |
front 9 What the provider should inform the client | back 9 Complete description of the treatment/procedure Description of the professionals who will be performing and participating in the treatment Description of the potential harm, pain, and/or discomfort the might occur Options for other treatment and the possible consequences of taking other actions The right to refuse treatment Risk involved if the client chooses no treatment |
front 10 To give informed consent, the client must do the following | back 10 Give it voluntarily Be competent and of legal age, or be an emancipated minor. (If the client is unable to provide consent, an authorized person must give consent) Receive sufficient information to decide based on an informed understanding of what is expected |
front 11 The nurse should job/ role and responsible for (informed consent) | back 11 Witness informed consent Ensuring that the provider provided the client the necessary information Ensuring that the client understood the information and in competent to give informed consent Having the client sign the informed document Notifying the provider if the client has more questions or does not understand any of the information provided (provider will be the one giving clarification) |
front 12 The nurse documents the following (informed consent) | back 12 Reinforcement of information originally given by the provider Questions that the client had were forwarded to the provider Use of an language assistance services |
front 13 Priority setting | back 13 It requires decisions to be made regarding the order in which: Clients are seen Assessments are completed Interventions are provided Steps in client procedures are completed Components of client care are completed |
front 14 Time management | back 14 Organize care according to needs and priority Use time saving strategies Spending time developing a plan of care will save time once the plan is implemented Complete one task before starting a new one |
front 15 Systemic vs. Local | back 15 EX: Prioritize a client in shock over a client who has a local injury |
front 16 Acute Vs. Chronic | back 16 EX: Prioritize a client with a new injury over a client who has a long term illness |
front 17 Actual vs. Potential | back 17 EX: Prioritize administration of medications to a client with acute pain over ambulating a client for DVT prevention |
front 18 Listen Vs. Assume | back 18 EX: Prioritize listening to clients understanding of a new illness |
front 19 Recognize Trends Vs. Transient finding | back 19 EX: Recognize gradual deterioration |
front 20 Complication Vs. Expected Findings | back 20 EX:Prioritize a change in condition for a new stroke vs. expected residuals from a past stroke |
front 21 Apply clinical knowledge to standards | back 21 EX: Prioritize medications with timing implications vs. prophylactic medications |
front 22 Maslow's Hierarchy | back 22 Physiological (the normal function of living organisms and their parts)needs take priority |
front 23 ABC Framework | back 23 Three basic needs for sustaining life (in order) Airway-highest priority Breathing- Needed for blood oxygenation to occur Circulation- Needed for oxygenation blood to reach tissues |
front 24 Safety/ Risk reduction | back 24 Give priority to the most imminent risk How significant is the risk in comparison to other options? |
front 25 Assessment/ Data collection first | back 25 Information must be gathered before you can intervene |
front 26 Survival Potential | back 26 Mainly used in mass casualties- gives priority to clients who have a reasonable chance of survival |
front 27 Least Restrictive/ Least invasive | back 27 Maintain client safety while using least restrictive methods |
front 28 Evidence- Based Practice | back 28 Use interventions that are researched based |
front 29 Transfers | back 29 Clients can be transferred from one unit, department, or one facility to another Continuity of care must be maintained as the client moves from one setting to another |
front 30 What should be communicated when transferring a client | back 30 Client medical diagnosis and care providers Client demographic information Overview of health status, plan of care, and recent progress Alterations that can precipitate an immediate concern Most recent vital signs and medications, including when a PRN was given Notification of assessments or client care needed within the next few hours Allergies Diet & activity prescriptions Presence of or need for specific equipment or adaptive devices (oxygen, suction, wheelchair) Advance directives and whether a client is to be reuscitated in the event of cardiac or respiratory arrest Family involvement in care and health care proxy if applicable |
front 31 Types of leadership styles | back 31 Autocratic/Authoritarian, Democratic, or Laissez- faire |
front 32 Autocratic/Authoritarian | back 32 Makes decisions for the group Motivates by coercion Communication occurs down the chain of command, or from highest management level downward through other managers to employees Work output by staff is usually high: good for crisis situations and bureaucratic settings Effective for employees with little or no formal education |
front 33 Democratic | back 33 Includes the group when decisions are made Motivates by supporting staff achievements Communications occurs up and down the chain of command Work output by staff is usually of good quality when cooperation and collaboration are necessary |
front 34 Laissez- Faire | back 34 Makes very few decisions and does little planning Motivation s largely the responsibility of individual staff members Communication occurs up and down the chain of command and between group members Work output is low unless an informal leader evolves from the group Effective with professional employees |
front 35 Types of Leader | back 35 Transactional, Transformational, Laissez-faire, Bureaucratic, and Situational |
front 36 Transactional leaders | back 36 Focuses on immediate problems, maintaining the status quo and using rewards to motivate followers |
front 37 Transformational leaders | back 37 They empower and inspire followers to achieve a common long-term vision |
front 38 Laissez-faire leaders | back 38 They're permissive and encourage decison making to take place throughout the group |
front 39 Bureaucratic (Authentic) leaders | back 39 Inspires others to follow them by modeling a strong internal moral code |
front 40 Situational leaders | back 40 Are flexible and can adapt their leadership style based on the situation at hand, often combining both autocratic and democratic leadership styles |
front 41 Critical Pathways | back 41 Can be used to support the implantation of clinical guidelines and protocols These tools are usually based on cost and length of stay parameters mandated by prospective payment systems (Medicare & Insurance companies) |
front 42 Who uses critical pathways | back 42 Case managers often initiate it but are used by many members of the interprofessional team |
front 43 What clinical pathways are specific to | back 43 To a diagnosis type and outline the typical length of stay and treatments |
front 44 When a client requires treatment other than what is typical and requires a longer stay(Critical pathways) | back 44 This is document as variance along with information describing why the variance occurred |
front 45 Reporting of Variance | back 45 Evaluate response to error/ occurrence Identify need/situation where reporting of incident/event/irregular occurrence/ variance is appropriate |
front 46 Stage 1: Latent Conflict | back 46 The actual conflict has not yet developed; however, factors are present that have a high likelihood of causing conflict to occur. |
front 47 Stage 2: Perceived Conflict | back 47 A party perceives that a problem is present, though an actual conflict might not actually exist. |
front 48 Stage 3: Felt Conflict | back 48 Those involved begin to feel an emotional response to the conflict. |
front 49 Stage 4: Manifest Conflict | back 49 The parties involved are aware of the conflict and action is taken. Actions at this stage can be positive and strive towards conflict resolution, or they can be negative and include debating, competing, or withdrawal of one or more parties from the situation. |
front 50 Stage 5: Conflict Aftermath | back 50 Conflict aftermath is the completion of the conflict process and can be positive or negative. |
front 51 Conflict Resolution Strategies | back 51 Open communication among staff and between staff and clients can help defray the need for conflict resolution. When potential sources of conflict exist, the use of open communication and problem-solving strategies are effective tools to de-escalate the situation |
front 52 Delegating and Supervising | back 52 A licensed nurse is responsible for providing clear directions when a task is initially delegated and for periodic reassessment and evaluation of the outcome of the task. |
front 53 Who RN's delegate | back 53 RNs must be knowledgeable about the applicable state nurse practice act and regulations regarding the use of PNs and APs. RNs delegate tasks so that they can complete higher level tasks that only RNs can perform. This allows more efficient use of all members of the health care team. QTC |
front 54 Who PN's can delegate | back 54 PNs can delegate to other PNs and APs. |
front 55 Delegation Factors | back 55 Nurses can only delegate tasks appropriate for the skill and education level of the health care team member who is receiving the assignment. RNs cannot delegate the nursing process, client education, or tasks that require clinical judgment to PNs or APs. PN and RN scope of practice differs from state to state, and it is important to know and comply with the state’s practice rules where the nurse is employed. |
front 56 Delegation and Supervision Guidelines | back 56 Use nursing judgment and knowledge related to the scope of practice and the delegatee’s skill level when delegating.
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front 57 Examples of tasks delegated to PN's | back 57 Monitoring findings (as input to the RN’s ongoing assessment) Reinforcing client teaching from a standard care plan Performing tracheostomy care Suctioning Checking NG tube patency Administering enteral feedings Inserting a urinary catheter Administering medication (excluding IV medication in some states) |
front 58 Examples of tasks delegated to AP | back 58 Activities of daily living (ADLs) Bathing Grooming Dressing Toileting Ambulating Feeding (without swallowing precautions) Positioning Routine tasks Bed making Specimen collection Intake and output Vital signs (for stable clients!!) |