West Coast University NURSING 121
West Coast UniversityNURSING 120SASHA A. RARANG, RN, MSN
IntroductionCore Competencies for Healthcare Professionals Roles of
the Nurse in Medical-Surgical NursingGordons Functional Health
PatternThe Nursing Process and Critical ThinkingNursing Diagnosis
for Patients with Complex Disorders.
Core Competencies for Healthcare Professionals What is a
Competency and Why is it Important?Competence is a multifaceted and
dynamic concept that is more than knowledge and includes the
understanding of knowledge, clinical skills, interpersonal skills,
problem solving, clinical judgment, and technical skills. Nursing
Professional Competencies11 CORE COMPETENCIES IN NURSING SAFE AND
QUALITY NURSING CAREMANAGEMENT OF RESOURCES AND ENVIRONMENT'SHEALTH
EDUCATIONLEGAL RESPONSIBILITYETHIC/MORAL RESPONSIBILITYPERSONAL AND
PROFESSIONAL DEVELOPMENTQUALITY IMPROVEMENTRESEARCHRECORD
MANAGEMENTCOMMUNICATIONCOLLABORATION AND TEAMWORK
A. Safe and Quality Nursing Care
1. Demonstrates knowledge based on the health/illness status of
individual groups. 2. Provides sound decision making in the care of
individuals/groups. 3. Promotes wholeness and well-being including
safety and comfort of patients.4. Sets priorities in nursing care
based on patients' need. 5. Ensures continuity of care.6.
Administers medications and other health therapeutics.7. Utilizes
the nursing process as framework for nursing. 8. Formulates a plan
of care in collaboration with patients and other members of the
health team.9. Implements planned nursing care to achieve
identified outcomes. 10. Evaluates progress toward expected
outcomes. 11. Responds to the urgency of the patient's condition.
B. Management of Resources and Environment Organizes work load to
facilitate patient careUtilizes resources to support patient care
Ensures availability of human resources Checks proper functioning
of equipment/ facilities. Maintains a safe and therapeutic
environment.Practices stewardship in the management of resources C.
Health Education Assesses the learning needs of the patient and
family.2. Develops health education plan based on assessed and
anticipated.3. Develops learning materials for health education. 4.
Implements the health education plan. 5. Evaluates the outcome of
health education.
D. Legal Responsibility Adheres to practice in accordance with
the nursing law and other relevant legislation including contracts,
informed consent Adheres to organizational policies and procedures,
local and national Documents care rendered to patients
E. Ethico-Moral Responsibility
Respects the rights of individuals/groups Accepts responsibility
and accountability for own decisions and actions 3. Adheres to the
national and international code of ethics for nurses.
F. Personal and Professional Development Identifies own learning
needs. Pursues continuing education. Gets involved in professional
organizations and civic activities. Projects a professional image
of the nurse. Possesses positive attitude towards change and
criticism.Performs function according to professional
standards.
G. Quality Improvement Utilizes data for quality
improvement.Participates in nursing audits and rounds Identifies
and reports variances.Recommends solutions to identified causes of
the problems.Recommends improvement of systems and processes.
H. Research
Utilizes varied methods of inquiry in solving problems.
Recommends actions for implementation. Disseminates results of
research findings.Applies research findings in nursing
practice.
I. Record Management Maintains accurate and updated
documentation of patient care.Records outcome of patient care.
Observes legal imperatives in record keeping.Maintains an effective
recording and reporting system.
J. Communication Utilizes effective communication in relating
with clients, members with the team and the public in general.
Utilizes effective communication in therapeutic use of self to meet
the needs of clients.Utilizes formal and informal channels.
Responds to needs of individuals, families, groups and communities.
Uses appropriate information technology to facilitate
communication.
K. Collaboration and Teamwork Establishes collaborative
relationship with colleagues and other members of the health team
for the health plan. Functions effectively as a team player.
Gordons Functional Health PatternsGordon's functional health
patterns is a method devised by Marjory Gordon to be used by nurses
in the nursing process to provide a more comprehensive nursing
assessment of the patient. A guide for establishing a comprehensive
nursing data base. These 11 categories make possible a systematic
and standardized approach to data collection, and enable the nurse
to determine the following aspects of health and human
function:GORDON Functional Health Patterns1. PATTERN OF HEALTH
PERCEPTION & HEALTH MANAGEMENT
How does the person describe her/ his current health? What does
the person do to improve or maintain her/ his health? What does the
person know about links between lifestyle choices and health? How
big a problem is financing health care for this person? Can this
person report the names of current medications s/he is taking and
their purpose? If this person has allergies, what does s/he do to
prevent problems? What does this person know about medical problems
in the family? Have there been any important illnesses or injuries
in this person's life?
2. NUTRITIONAL - METABOLIC PATTERN
Is the person well nourished? How do the person's food choices
compare with recommended food intake? Does the person have any
disease that effects nutritional- metabolic function?
3. PATTERN OF ELIMINATION
Are the person's excretory functions within the normal range?
Does the person have any disease of the digestive system, urinary
system or skin?
4.PATTERN OF ACTIVITY & EXERCISE How does the person
describe her/ his weekly pattern of activity and leisure, exercise
and recreation? Does the person have any disease that effects her/
his cardio-respiratory system or musculo-skeletal system?
5. COGNITIVE - PERCEPTUAL PATTERN
Does the person have any sensory deficits? Are they corrected?
Can this person express her/ himself clearly and logically? How
educated is this person? Does the person have any disease that
effects mental or sensory functions? If this person has pain,
describe it and it's causes.
6. PATTERN OF SLEEP & REST
Describe this person's sleep-wake cycle. Does this person appear
physically rested and relaxed?
PATTERN OF SELF PERCEPTION & SELF CONCEPT Is there anything
unusual about this person's appearance? Does this person seem
comfortable with her/ his appearance? Describe this person's
feeling state?
8. ROLE - RELATIONSHIP PATTERN How does this person describe
her/ his various roles in life? Has, or does this person now have
positive role models for these roles? Which relationships are most
important to this person at present? Is this person currently going
though any big changes in role or relationship? What are they?
9. SEXUALITY - REPRODUCTIVE PATTERN
Is this person satisfied with her/ his situation related to
sexuality? How have the person's plans and experience matched
regarding having children? Does this person have any disease/
dysfunction of the reproductive system?
10. PATTERN OF COPING & STRESS TOLERANCE
How does this person usually cope with problems? Do these
actions help or make things worse? Has this person had any
treatment for emotional distress?
11. PATTERN OF VALUES & BELIEFS
What principals did this person learn as a child that are still
important to her/ him? Does this person identify with any cultural,
ethnic, religious, regional, or other groups? What support systems
does this person currently have?
Gordon's Functional Patterns Application Test
Check your understanding of the differences between these 11
functional patterns, and how a nursing diagnosis might express a
dysfunction in one or more patterns.
Identify the specific functional pattern(s) that would be
at-risk or dysfunctional for the following nursing diagnoses to be
made:
1. Social isolation related to immobility (presence of
contagious infection).2. Chronic low self-esteem related to obesity
3. knowledge deficit (signs of hypoglycemia) (signs and symptoms of
hyperglycemia)4. Spiritual distress related to inability to
practice religious rituals 5. Diversional activity deficit related
to long-term confinement to home. 6. Sleep pattern disturbance
related to sensory overload. 7. Ineffective family coping:
disabling related to recurrent marital discord.8. Role performance
disturbance related to effects of chronic pain. 9. Potential for
violence directed at others related to effects of
hallucinations.The Nursing Process AssessmentNursing
assessmentCollection and verification of dataAnalysis of
dataDatabaseConsists of clients perceived needs, health problems,
and responses to problemsEx: Newly diagnosed Diabetes Mellitus Type
1 client coming to physicians office for a routine appointment.
Clients verbalized that she has been losing weight ( 7 pounds in 2
weeks), keep waking up at night to go to bathroom and always
thirsty. Her mood also changed irritable and moody. The MD ordered
to check clients blood sugar level. After checking noted BSL is 600
mg/dl.AssessmentSubjective dataObjective dataSources of
dataClientFamily and significant othersHealth care teamMedical
recordMethods of Data CollectionInterviewNursing Health History
Biographical Information Client expectations Present illness or
health concerns Health history Family history Environmental history
Psychosocial history Spiritual health Review of systems
Documentation of findingsPhysical Examination
Data DocumentationThe last component of assessmentLegal and
professional responsibilityRequires accurate and approved
terminology and abbreviations
Nursing Diagnosis1. Medical diagnosisA clinical judgment about
the client in response to an actual or potential health problem2.
Nursing diagnosisThe identification of a disease condition based on
specific evaluation of signs and symptoms3. Collaborative problemAn
actual or potential complication that nurses monitor to detect a
change in client status
Critical Thinking and the Nursing ProcessDiagnostic reasoningA
process of using assessment data to create a nursing
diagnosisDefining characteristicsClinical criteria or assessment
findingsClinical criteriaObjective or subjective signs and
symptoms
Concept Mapping Nursing DiagnosisA way to graphically represent
the connections between concepts and ideas that are related to a
central subject such as a clients health problem.Concept maps
promote problem solving and critical thinking skills by organizing
complex client data, analyzing concept relationships and
identifying interventions.
Nursing Diagnosis: Application to Care PlanningBy learning to
make accurate nursing diagnoses, your care plan will help
communicate the clients health care problems to other
professionals.A nursing diagnosis will ensure that you select
relevant and appropriate nursing interventions.
Planning Establishing PrioritiesHelps nurses to anticipate and
sequence nursing interventions Classification of
priorities:HighIntermediateLow
Critical Thinking in Establishing Goals and Expected
OutcomesGoalA broad statement that describes the desired change in
a clients condition or behaviorAn aim, intent, or endExpected
outcomeMeasurable criteria to evaluate goal achievement
Guidelines for Writing Goals Combining goals and outcomes
statementsClient centeredSingular goal or
outcomeObservableMeasurableTime limitedMutual factorsRealistic
Implementing Nursing CareCritical Thinking in
Implementation.Review the set of all possible nursing
interventions.Review all possible consequences associated with each
possible nursing action.Determine the probability of all possible
consequences.Make a judgment of the value of that consequence to
the client.
EvaluationEvaluation is an ongoing process.If outcomes are met,
client goals are met.Positive evaluations occur when nurses meet
desired outcomes.Positive evaluations lead nurses to conclude that
interventions were successful.