ZOYA MINASYAN RN-MSN-EDU Nursing Practice Today
Jan 06, 2016
ZOYA MINASYANRN-MSN-EDU
Nursing Practice Today
CURRENT NURSING PRACTICE
Domain of Nursing PracticeWide variety of roles and responsibilities to meet the health care needs of society.
CURRENT NURSING PRACTICE
Definitions of Nursing(ANA American Nursing Association)
Is a protection, promotion, and optimization of health and abilities, prevention of illness and injury, alleviation of suffering through the diagnosis and treatment of human response, and advocacy in the care of individuals, families, communities, and populations.
CURRENT NURSING PRACTICE
Nursing’s View of Humanity-An individual has
physiologic, psychologic (or emotional), sociocultural (or interpersonal), spiritual, and environmental
components.-No two individuals are exactly alike.
CURRENT NURSING PRACTICE
Scope of Nursing Practice entry level( work with other health providers), specialty(critical care, pain management,
pediatric, psychiatric, med-surg, dialysis), certifications(ongoing: oncology, DM
Delivery of Nursing Care Team nursing-team leader Primary nursing-one designated nurse was
responsible for planning the pt’s care Managed care-case management
Critical thinking Confidence, creativity, flexibility, open minded,
intelligent, information seeking, logical reasoning.
INFLUENCES ON FUTURE NURSING PRACTICE
Healthy people 2010 Physical activity Overweight and obesity Tobacco use, substance abuse Responsible sexual behavior Mental health Injury and violence Environmental quality Immunization Access to health care
INFLUENCES ON FUTURE NURSING PRACTICE
INFLUENCES ON FUTURE NURSING PRACTICE
Evidence- based practice EBP It is a use of evidence based on research,
pt’s assessment, clinical experience, pt’s preferences and values in decision making.
JCAHO joint Commission on Accreditation of Health Organizations now requires that practice be based on evidence.
INFLUENCES ON FUTURE NURSING PRACTICE
Five steps of the Evidence- based practice EBP
1. Ask question by using PICO formatP- patient interestI- InterventionC-Comparison of interestO- Outcome(s) of interest
2. Collect the evidence.3. Synthesize the evidence.4. Integrate all evidence in making a decision or
change.5. Evaluate the decision.
FIVE STEPS OF THE EVIDENCE- BASED PRACTICE(EBP)
STANDARDIZED NURSING TERMINOLOGY
NANDA-North American Nursing Diagnosis Associationwww.nanda.org; Appendix B in your textbook
NOC- Nursing Outcome Classificationwww.nursing.uiowa.edu/noc/Ex: The pt will maintain normal vital signs in
respond to activity in 2 days. NIC- Nursing Intervention Classification
www.nursing.uiowa.edu/nic/Ex: Monitor pt’s oxygen response(Vital signs)Encourage, assist, provide, monitor, collaborate
with PT and OT, teach, etc…
NURSING INFORMATICS
Is a specialty nursing science, computer science and information science
in collecting, identifying, processing and
managing data an informationto
support nursing practice, administration, education, research, and the expansion of knowledge.
NURSING PROCESS IN NURSING PRACTICE
Independent-more autonomous, nurse initiated
Dependent-when carrying out med orders, diagnostic tests and orders
Collaborative-including nurse, physician, IV med’s, providing emotional support
NURSING PROCESS IN NURSING PRACTICE
NURSING PROCESS IN NURSING PRACTICE
AssessmentCollection of data
subjective –interviewing patient; whatever patient says
objective-observed and measured
NURSING PROCESS IN NURSING PRACTICE
Diagnosis Phase Data analysis and problem identification Nursing diagnoses
NANDA nursing
NURSING PROCESS IN NURSING PRACTICE
Diagnosis Phase
One part statement: Readiness for enhanced nutrition.
Two part statement:Imbalanced nutrition: less than body requirements r/t limited income for food purchase.Risk for aspiration r/t impaired swallowing.
Three part statement: problem-etiology-signs and symptoms(PES).
Pain r/t surgical incision, localized pressure, edema, as evidenced by verbalization of pain, isolation and withdrawal.
NURSING PROCESS IN NURSING PRACTICE
Planning Phase Priority setting Identifying outcomes
Nursing Outcomes Classification (NOC)Short outcome-The pt will maintain normal VS in
response to activity in 2 days.Long outcome- the pt will identify a realistic activity
level to achieve or maintain by D/C. Determining interventions
Nursing Interventions Classification (NIC)Choosing activities (managing, monitoring, teaching…)
NURSING PROCESS IN NURSING PRACTICE
Implementation Phase Delegation and assignment Nursing interventions that require independent
nursing knowledge, skills, or judgment, such as assessment, pt teaching, and evaluation of care, cannot be delegated.
(Using activates)
NURSING PROCESS IN NURSING PRACTICE
NURSING PROCESS IN NURSING PRACTICE
Evaluation PhaseAs a result of evaluation, the nurse
determines whether the plan should be maintained or discontinued.
NURSING PROCESS IN NURSING PRACTICE
Documentation Nursing care plans
Specific directions for carrying out the planned intervention, also used as a teaching /learning tools.
Concept maps Visual diagrams for pt problems and interventions
Clinical (critical) pathways includes care plan, documentation, interventions