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LOBBYING & ADVOCACY:

American Nurses Association (ANA)

Texas Nurses Association (TNA)

EDUCATION & STANDARDS:

National League for Nursing (NLN)

National Student Nurses Association (NSNA)

LICENSURE:

Texas Board of Nursing (TX BON)

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Requires specialized education

Requires licensure

Has a theoretical body of knowledge defining skills, abilities & norms

Provides a specific service

Members in a profession have autonomy in decision making & practice

Has a code of ethics

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State Practice Acts:

Passed by legislature and enforced by board of nursing

Defines scope of practice + minimum standards for education, training, and qualifications.

Scope of Practice:

legally defines what professional nurses are licensed to do

Delegation:

Process of assigning another competent member of the health care team to be responsible for aspects of patient care (e.g., assigning nurse assistants to bathe a patient).

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Nursing incorporates the art and science of caring and focuses on:

the protection, promotion, and optimization of health and abilities;

prevention of illness and injury; facilitation of healing;

and alleviation of suffering through compassionate presence.

Nursing is the diagnosis and treatment of human response, and advocacy in the care of individuals, families, groups, communities, and populations in recognition of the connection of all humanity.

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ADPIE

Assessment:

RN collects pertinent data and information relative to the healthcare consumer’s health or the situation.

Diagnosis:

RN analyzes the assessment data to determine the actual or potential diagnoses, problems, and issues.

Outcomes Identification: RN identifies expected outcomes for a plan individualized to the healthcare consumer or the situation.

Planning:

RN develops a plan encompassing strategies to achieve expected outcomes.

Implementation:

RN implements the identified plan.

Coordination of Care: RN coordinates care delivery.

Health Teaching and Health Promotion: RN employs strategies to teach and promote health and wellness.

Evaluation:

The registered nurse evaluates progress toward attainment of goals and outcomes.

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Integrity

Accountability

Credibility

Advocacy

Compassion

Respect

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ENTRY LEVEL:

Diploma Programs:

Non-Degree programs offered by hospitals systems; eligible for NCLEX & licensure; rare

Associate Degree (ADN):

Offered by accredited community colleges; eligible for NCLEX & RN license; common

Baccalaureate Degree (BSN):

Offered by colleges & universities; 4 years or 14 mo. for accelerated; becoming more in-demand by hospitals seeking magnate status; eligible for NCLEX & RN licensure

Graduate Degree Entry (MSN):

non-nursing BSN; eligible for NCLEX & RN licensure

ADVANCED PRACTICE:

Graduate Degree (MSN,PhD, DNP):

Advanced clinical specialty; education; or specialization.

NP, CNS, Nurse educator or administrator

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1. Novice

2. Advanced Beginner

3. Competent

4. Proficient

5. Expert

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1850s/60s - Britain / Crimea

First practicing nurse epidemiologist whose statistical analyses connected poor sanitation with incidence of cholera & dysentery.

Volunteered with British during Crimean War; “lady with the lamp”; worked to improve battlefield hospital santiation and nutritional practices; reduced mortality rate from ~43% to ~2% in 6 months.

Formed 1st school of nursing at St. Thomas Hospital in London.

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1805; also active 1850s/60s - Carribean/ British Colonial areas/ Crimea

Nurse from Jamaica (African/Scottish descent); active in Jamaica & Panama where she was known for “cure for cholera”; practiced traditional herbalism;

Also volunteered in Crimean War despite being rejected from Army Hospitals; ran an informal but well respected battlefield hospital for troops; Sidelined from noted history for many decades.

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1860’s - US Civil War

Founded American Red Cross; cared for soldiers during American Civil War in battlefield hospitals

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Dorothea Dix & Mary Ann Ball (Mother Bickerdyke)

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Dorothea Dix & Mary Ann Ball (Mother Bickerdyke)

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1860's - US Civil War

Organized hospitals and ambulances, appointed nurses, cared for wounded soldiers; oversaw and regulated supplies to troops.

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1860's - US Civil War

Active in the underground railroad movement; assisted in leading more than 300 slaves to freedom; practicing nurse caring for Union soldiers in wartime.

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1880's - U.S.

First professionally trained African-American nurse in the U.S.; brought forth an awareness of cultural diversity and respect for the individual, regardless of background, race, color, or religion.

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1890's - U.S.

Founded Nurses Associated Alumnae of US & Canada in 1896 - which became ANA in 1911; wrote nursing textbooks; one of original founders of American Journal of Nursing.

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1890's - U.S., NYC

Opened Henry Street Settlement in NYC; community nursing focusing on providing care to the poor/disenfranchised; focused on community health model

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Inpatient: patient stays and facility while receiving care

Acute Care, Skilled Nursing Facility, Rehabilitation Center, Long Term Care (Nursing Home), Psychiatric Hospital

Outpatient or Ambulatory Care: patient receives care at facility and goes home

Clinic, Physician’s Office, Urgent Care Center, Surgical Center, Home Health Care, Mental Health Center, Community Health Center, School Health Clinic, Occupational Health Service

Community: provides non-medical services integral to patient care & QOL

Adult Day Care, Respite Care, Meals On Wheels, Transport Services, Case Management

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Health Care Costs and Quality (including Patient Satisfaction)

Nursing Shortage

Competency (QSEN – Quality and Safety Education for Nurses)

Patient-centered Care

Magnet Recognition Program ® for hospitals

Technology in Health Care (EHR/EMR, medical devices, advanced surgical technology, etc.)

Health Care Disparities (including Social Determinants of Health)

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Who is TJC?

The major accrediting body for health care institutions/ orgs funded by Medicare and Medicaid.

Accreditation is prestigious & necessary to receive reimbursement for care.

Agencies are evaluated every 3 years

What does TJC Do?

Evaluates care in an organization and determines if overall care meets quality standards

Requires hospitals to submit error reports & identify key sentinel events

Sentinel Events: An event that has the potential for great harm; involving death or loss of limb or function

Issues the National Patient Safety Goals (NPSGs).

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HOSPITAL CONSUMER ASSESSMENT OF HEALTH PLANS SURVEY (HCAHPS)

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HOSPITAL CONSUMER ASSESSMENT OF HEALTH PLANS SURVEY (HCAHPS)

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National program for collecting & providing health care information from the consumer perspective

29-Q Survey / Randomly selected patients discharged from hospital within 48hrs - 6 weeks:

Communication responsiveness, pain management, discharge information, cleanliness & quietness of hospital environment

Results are publicly reported online

Creates benchmarks

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Used when errors occur

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Prioritizing Your Care

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Delegation:

1. Transferring authority to a competent individual for completing selected nursing tasks in a selected situation.

2. Usually an RN > LPN or CNA

3. Delegated assignment must be in the person's scope of practice

When Delegating:

Be clear, concise, correct & complete

Know what needs to be done and how

Know skills/competency/scope of person doing task

Follow-up with person doing task

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S - Situation - Who you are / Who the patient is; why you are calling

B - Background - PT MedHx and info as it pertains to the situation

A - Assessment - What have you checked? Should be relevant to the situation.

R - Recommendation - What are you recommending? What recommendation does the HCP have?