1. Coordination of care 2. Health teaching and health promotion 3. Consultation
What should precede nursing interventions?
Quality assessment, diagnosis, and planning
What skills may be utilized in nursing interventions?
Cognitive skills, Interpersonal skills, and Technical skills
How may nursing care be communicated?
In writing (charting, worksheets) or verbally (in person or recorded)
What should be considered when planning a nursing intervention? (the client should ALWAYS be considered)
1. Your understanding of the plan (know what you are doing) 2. Determine if you have the knowledge, skills, and authority 3. Facility protocols for who should perform intervention 4. Client's status 5. Possible outcomes 6. Ability to obtain necessary resources
What are the components of the evaluation phase of the nursing process?
1. Determine client's progress toward achievement of goals/outcomes 2. Review effectiveness of the nursing care plan 3. Decide whether or not plan needs to be modified
How is the evaluation phase carried out?
By critiquing: each phase of the nursing process, whether interventions were carried out, were unclear or unreasonable, and by making necessary modifications, implementing the modified plan, and beginning the nursing process again
How may the quality of nursing care be evaluated?
Quality assurance, Quality improvement, The Joint Commission (JCAHO), and Nursing-sensitive Indicators
What is Quality assurance?
An ongoing systematic process generally designed to evaluate structure, process, and outcome of an institution or provider in regards to client care.
What is Quality improvement?
An approach to care improvement (usu. involves nat'l groups - IOM) by conducting user-driven research, disseminating quality measurement reports, collaborating to implement EBP, ensure continuous learning
What is the focus of The Joint Commission?
improve safety/quality through accreditation of healthcare organizations, emphasis on sentinel events causing death or serious injury (physical/psychological)
What are Nursing-sensitive Indicators?
voluntary standards of care allowing nurses to evaluate care given, involve Serious Reportable Events (SRE) built on IOMs "never events" - the database is ANA proprietary
What are the common sentinel events?
Most common is wrong site surgery, others include medication errors and errors due to similar abbreviations
What are types of nursing audits?
concurrent (occurs during treatment), retrospective (after discharge), peer-review (audit of an individual), nursing audit (review of nursing care via records)