NR 226 Week 2 Concepts; Managing Patient Care

$15.00

Contributor

Rosemary Clooney

Category

Nursing

Course

NR 226 Fundamentals: Patient Care

Institute

Chamberlain

Pages

24

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Managing Patient Care Managing Patient Care Prepare: Managing Patient Care Nursing Care Delivery Match the nursing care delivery system to its key characteristics. Patient Centered Care: Adapting care as the needs of an individual change. Taking time to assure the person understands new information about their health. Conveying respect for the individual’s health and lifestyle choices. Total Patient Care: RN responsible for all care in a shift. Requires a high degree of interprofessional collaboration. Frequently used to care for critically ill patients. Case Management: Links health services across all level of care. Clinicians focus on groups of patients with specific illnesses. Goal is to improve outcomes while reducing overall cost of care. Responsibility The obligation to act Autonomy The choice to act Authority The power to act Accountability The ownership of the act Four Principles of the Healthcare Team (RAAA) Match the principle to the correct definition. Five Rights of Delegation What are the five rights of delegation? Select all that apply. Right Circumstances Right Place Right Supervision/Evaluation Right Patient Right Time Right Task Right Person Right Direction/Communication Right Documentation Self-Check: Nursing Role Nursing Role The nurse whose work focuses on lowering the cost of care without compromising quality is working in which role? Community health Home care Rehabilitation nurse Case manager Self-Check: RAAA RAAA 0576172For each situation indicate if the balance of responsibility, autonomy, authority, and are accountability is unequal by placing a check in the column associated with the factor that is out of balance. If the RAAA is balanced, place a check in the Balanced RAAA column. More than one factor may be affected in a situation. Self-Check: Delegation and Maslow Delegation 0392021For each instance of delegation, click to specify which of the five rights of delegation is being addressed. There may be multiple rights addressed for each example. Self-Check: Interprofessional Communication Match the positive communication behavior to the category in which it falls. Value team input Document patient data accurately and in a timely manner Focus on patient needs and outcomes during all communication Actively listen to, and address, concerns Seek clarification when unclear of the treatment plan Exchange relevant information within the team Set expectations for what, where, and when to communicate Repeat what you’ve heard so the person who shared information can confirm you understood Use the I-SBAR (Information-Situation-Background-Assessment-Request) format for critical conversations Focus on the patient and their care when conflict arises Coordinate workload with colleagues Care for a colleague’s assignment if one of the patients needs their attention Delegate care appropriately Assess capabilities of individuals within the team Self-Check: Knowledge for Nursing Knowledge for Nursing The experienced nurse is precepting a nurse during their orientation to the facility. The orienting nurse has reviewed the policy and procedure manual for key nursing care activities and is preparing to bathe a patient with an indwelling urinary catheter. Before entering the patient’s room, the experienced nurse hands the orienting nurse packets of povidone-iodine (Betadine) swabs to cleanse the urinary catheter and perineum. The orienting nurse inquires if the patient has a condition that requires cleansing with something stronger than soap and water, which is what the facility policy and procedure manual recommends. Both nurses reviewed the patient’s EHR and current procedure for catheter care to verify the correct type of catheter care was provided for this patient. What type of learning occurred in this situation? Employer sponsored Formal Experience Internet based Reflect: Managing Patient Care Nursing Care Delivery Systems A patient who is critically ill will benefit most from being admitted to a nursing unit that utilizes which type of nursing care deliver system? Interdisciplinary Care Holistic Patient-Centered Total-Patient Care To Delegate, or Not to Delegate? Which aspects of nursing care should never be delegated to an unlicensed assistive personnel (UAP)? Select all that apply. Delivering flowers to a patient Nursing diagnosis Evaluation of patient outcomes Bathing a patient on total bedrest Transporting a patient to a test Patient assessment Nursing Attributes – Patient-Centered Care 0576172For each statement below, indicate if it reflects the definition of Patient-Centered Care (PCC), or an attribute of PCC Knowledge, PCC Skills, or PCC Attitudes by checking the correct box on the table. Note: Each statement will match only one column (Patient-Centered Care, Knowledge, Skills, or Attitudes). Supervision While Delegating For each aspect of the Right Supervision/Evaluation step of delegation indicate who is responsible by placing a check in the Nurse or Unlicensed Assistive Personnel (UAP) column. Each aspect may apply to both colleagues. 00 Imbalance of RAAA in Conversation The nurse is caring for an elderly client who is cooperative and pleasant. About two hours into the shift the client says, “You are so pretty and could be beautiful if you did not have acne.” The nurse thanks her for the compliment, finishes administering medications, assures the client has what she needs, and leaves the room. Over the next several hours the client continues to comment on the nurse’s acne, despite the nurse’s request that she not. When the nurse realizes their emotions may interfere with their care of the client, they speak with their nurse manager and the client is assigned to another nurse for the remainder of the shift. 0374356In the table below, place a check to indicate which factor is imbalanced in this communication. If all factors are balanced, place a check in Balanced RAAA. Unexpected Discovery The nurse asks an Unlicensed Assistive Personnel (UAP) to total the shift intake and output for a group of patients to which the UAP is not assigned. After clarifying the nurse’s expectations related to time of completion and reporting back, the UAP enters the room of a patient with IV fluids infusing. The Intake and Output Record does not include an intake amount for IV fluids, though. What should the UAP do? Total the values without the IV fluid. Omit totaling the shift I&O for this patient. Inform the nurse that the IV fluid total is missing. Total the output and let the nurse total the input. RAAA in Action The nurse is caring for a patient experiencing an extremely low blood pressure. The health care provider prescribes a vasoconstrictive medication with which the nurse is unfamiliar. When considering which action to take next, the nurse considers which aspects of RAAA? Select all that apply. Responsibility Authority Autonomy Accountability Delegation Four hours after delegating the task of taking a patient’s vital signs to an Unlicensed Assistive Personnel (UAP) colleague, the nurse notes in the documentation that the blood pressure reading was dangerously high. The nurse approaches the UAP and lectures them for not reporting the abnormal reading immediately. The UAP tells the nurse that it is not their job to make sure the nurses look at the chart. 0553312Determine if the Nurse and/or the UAP properly incorporated RAAA and the Five Rights of Delegation into their actions by dragging Nurse and/or UAP to the correct column. Remember, it can be either the Nurse, the UAP, or both for each row. Clinical Care Coordination Prepare: Clinical Care Coordination Shared Leadership Characteristics Indicate which leadership characteristics are required of the nurse leader and which are required by the staff nurse by placing a check in the appropriate column. Note, some characteristics may apply to both. 00 Value of Clinical Decisions The nurse uses clinical decision making to keep the health care team focused on actions that move the client toward health. Client’s Valuables When admitting a client to an acute care facility (hospital), the nurse addresses safe keeping of the client’s belongings. Place the actions in the order in which the nurse completes them, starting with the first. Ask the client what belongings they brought with them. List the belongings in the electronic health record (EHR), with as much detail as possible for accuracy. 3. Advise the client that all items of value should be sent home for safe keeping. Note the disposition of items on the inventory within the EHR. Document that the client was informed of valuables policy and elected to dispose of items as noted on the Valuables Inventory. Self-Check: Keys to Good Clinical Decisions Which factors increase the quality of clinical decisions made by the nurse? Select all that apply. Nurse’s use of open ended questions. Nurse’s knowledge of health and illness. Ability of the nurse to organize data. Nurse following up on cues within the assessment data.

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