Nursing Clinical Practice

8/2/2019 Nursing Clinical Practice

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Clinical Practice

atNorth Shore-Long Island Jewish

Health System


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Presentation Chapters

Chapter I: Collaborative Care

Chapter II: Professional Nursing Practice (RNs only)

Chapter III: Evidence-based PracticeChapter IV: Orientation Process:

-What to expect

Chapter V: Essentials for Getting Started:-Requirements and Study guides


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I. Collaborative Care


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PATIENTSCOMEFIRST

Philosophy of Clinical Practice


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EXCELLENCE CARINGHONORING THEHUMAN SPIRIT

COLLABORATION PROFESSIONALISM LEADERSHIP SAFETY

PATIENTSCOME

FIRST

Health Care Team

Practice Environment(Structure)

Outcomes

Patient ExperienceFinancial Performance

Quality

Care Delivery Model(Process)

COLLABORATIVE CARE MODEL

Ex: Resources:Human

EquipmentSuppliesFinancial

to support careof our patients

Ex: Human Caring ModelRBC

Patient Safety ModelTeam STEPPS

Evidence Based PracticeKBC

Innovation & ExcellenceMicrosystems,

Six Sigma, Lean,Capstone, FTD

Ex: Patient Satisfaction,Staff Engagement,

Patient Safety,Quality Outcomes,

Productivity & Efficiency,Predictability,Importance of Documentation


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Culturally and LinguisticallyAppropriate Health Care

Immediate

communicationin any language


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II. Professional Nursing Practice


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Nursing

Nursing is the protection, promotion, and

optimization of health and abilities,prevention of illness and injury, alleviation of

suffering through the diagnosis andtreatment of human response and advocacyin the care of individuals, families,communities and populations.

Nursings Social Policy Statement(ANA, 2003)


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NYS NURSE PRACTICE ACTEducation Law: Article 139

Definition of practice of nursing

http://www.op.nysed.gov/article139.htm
http://www.op.nysed.gov/article139.htmhttp://www.op.nysed.gov/article139.htm


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Nurse Practice Act

Diagnosing
http://images.google.com/imgres?imgurl=http://www.sco.uncc.edu/ans/pictures/corner.jpg&imgrefurl=http://www.sco.uncc.edu/ans/links.html&usg=__9YtP6y79SSfAqRhbrr5AFULMs9Q=&h=347&w=540&sz=32&hl=en&start=2&tbnid=B2ee1NNc6l2hsM:&tbnh=85&tbnw=132&prev=/images%3Fq%3Dnursing%2Bpictures%26gbv%3D2%26hl%3Den


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Nurse Practice Act

Treatment


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Nurse Practice Act

Human Responses


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Scope and Standards ofNursing Practice

Standards of Practice

Standards of ProfessionalPerformance


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Standards of Practice

Assessment

DiagnosisOutcomes Identification

Planning

ImplementationEvaluation


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Evaluation1. Monitor client outcomes

2. Resolve, continue, revisethe current plan for care

Implementation1. Carry out the nursing

orders

2. Document the nursingcare and clientresponses

Planning1. Prioritize problems

2. Identify measurableoutcomes (goals)

3. Select Nursing Interventions

4. Document the plan of care

Diagnosis

1. Analyze data

2. Identify nursing diagnosesand collaborative problems

Assessment

1. Collect data

2. Organize data

NURSING PROCESS


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Standards of ProfessionalPerformance

Quality of Practice

Education

ProfessionalPractice Evaluation

Collegiality

Collaboration

Ethics

Research

Resource Utilization

Leadership


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ANA CODE OF ETHICShttp://www.nursingworld.org/MainMenuCategories/EthicsStandards/CodeofEthics.aspx

1. The nurse, in all professionalrelationships, practices withcompassion and respect for the inherentdignity, worth, and uniqueness of everyindividual, unrestricted byconsiderations of social or economicstatus, personal attributes, or the nature

of health problems2. The nurses primary commitment is to

the patient, whether an individual,family, group or community


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Code of Ethics

3. The nurse promotes, advocates for, andstrives to protect the health, safety, andrights of the patient

4. The nurse is responsible and accountable forindividual nursing practice and determinesthe appropriate delegation of tasks

consistent with the nurses obligation toprovide optimum patient care


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Code of Ethics

5. The nurse owes the same duties to self as toothers, including the responsibility to preserveintegrity and safety, to maintain competence,and to continue personal and professional

growth

6. The nurse participates in establishing,maintaining, and improving health care

environments and conditions of employmentconducive to the provision of quality health careand consistent with the values of the professionthrough individual and collective action


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Code of Ethics7. The nurse participates in the advancement of

the profession through contributions topractice, education, administration, andknowledge development

8. The nurse collaborates with other health

professionals and the public in promotingcommunity, national, and international effortsto meet health needs

9. The profession of nursing as represented byassociations and their members, is responsiblefor articulating nursing values for maintainingthe integrity of the profession and its practice,

and for shaping social policy


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Theoretical and ConceptualFrameworks

Florence Nightingale

Jean Watson


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The most important

practical lesson that can

be given to nurses is to

teach them what to

observe how to observe. . .

(Nightingale, 1860)


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Nurse-Patient-EnvironmentRelationship

Environment ofCaring/Healing/Safety

Ethical and Spiritual

Components of Care

Patient Advocacy andCritical Thinking


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Theory of Human Caring

...we learn from one another howto be human by identifyingourselves with others, findingtheir dilemmas in ourselves.What we all learn from it is self-knowledge. The self we learnabout is every self. It isuniversal - the human self. Welearn to recognize ourselves inothers(it) keeps alive ourcommon humanity and avoids

reducing self or other to themoral status of object.(Watson, 1985/1988, pp. 59-60).


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Theory of Human Caring

TranspersonalCaringRelationships

Caring Moments

Caring (Healing)Consciousness


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Professional Development

Lifelong learning

Continuing education

Professional organizations

Networking

Board certification


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What is my responsibility nowthat Im the Nurse?

Patient safety is

an ethical

imperative fornurses, and you

have the

responsibility totake all measures

to ensure patient

safety.


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RN JOB DESCRIPTION

Utilizes the nursing process

Coordinates plan of care

Adheres to safe medicationpractices

Educates patients and families

Discharge planning

Documentation


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III. Evidence-based Practice


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STANDARDS OF CARE

Policies, procedures, protocols

Clinical practice guidelines


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Micromedex


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IV. Orientation ProcessWhat to expect


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Clinical Practice Orientation

BeginningsWeek 1

Week 2

Week 3

Site, Unit Orientation

Unit, Role Orientation

Orientation Overview


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4 Day Clinical Practice Orientation

Performance AssessmentsDay 1

You will be asked to individually

demonstrate head to toe physicalassessment using a simulation manikin

You will be asked to individuallydemonstrate med math calculation


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Introduction to SimMan


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Simulated Patient Room


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Applied Clinical Practice

Transition Skills

Specialty Orientation


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Your Orientation Experience

Adult learner expectations:self directedness

-accountability

Assessment and validation measurement

Application of learned information

Pathway methodology

Competency demonstration


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What is COMPETENCY?

. . . the ability to fulfill responsibilityindependently, safely, andconsistently

E amples of Competenc E pectations


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Hand Hygiene Patient IdentificationAccurate Medication Dose

Calculation andAdministration EffectiveCommunication

Examples of Competency Expectations

Fall Prevention Pressure UlcerPrevention

Medication Reconciliation Patient Assessment and

Intervention


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Competency Validation Methods

Post-assessments

Return demonstration

Simulation and debriefing


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V. Essentials for Getting Started-Requirements and Study guides


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Welcome Letter

Supplies

Professional attire

Punctuality

In the event of an emergency . . .


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Orientation Schedule

Day

Time -Punctuality

Locationnote carefully

Content

Be Prepared

National Database of


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National Database of

Nursing Quality Indicators website


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Medication Math Study Guide

Practice Questions and answer key

Be Prepared for the math calculation assessmenton Day 1 of System orientation!

Bring:

Calculator

Make sure you reviewed the Drug list. You will

be asked to administer these meds

Drug reference guide


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Clinical Simulation Study Guide

Detailed Study Guide is provided

Be Prepared for your 1:1 simulationassessment on Day 1 of System

orientation!

You will be asked to demonstrate

performance of a head to toeassessment comprehensive of all areasincluded in the study guide


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Orientation Locations

Directions to Patient Safety Institute

Directions to Institute for Nursing

Parking at Institute for Nursing


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[email protected]

718 470- 8066


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Welcome Aboard!

Nursing Clinical Practice

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