**POWERPOINT**

TEST 1:
Accountability

Learning Outcomes from blackboard and syllabus:

1. Define nursing as an art and a science.
Deliver care artfully with compassion, caring, and respect for each patient's dignity and
personhood. As a science nursing practice is based on a body of knowledge that is continually
changing with new discoveries and innovations.
2. Identify major historical and social events that have shaped current nursing practice.
Florence Nightingale: battlefield sanitation, organized training. First practicing nurse
epidemiologist.
Clara Barton: American Red Cross
Dorothea Lynde Dix: organized hospitals, regulated supplies to troops
Mary Ann Ball (mother Bickserdyke): organized ambulances and walked battlefields at night
looking for
wounded soldiers
Harriet Tubman: Underground railroad
Mary Mahoney: first professionally trained African American nurse; focused on relationships
between cultures
and races
Isabel Hampton Robb: founded ANA, made many textbooks
Lillian Wald & Mary Brewster: opened henry Street Settlement, focused on health needs for poor
New
Yorkers. First to practice autonomy and critical thinking.
Mary Adelaide Nutting: first nursing professor at Columbia University in 1906
Social nursing: lobby for health care legislation to meet the needs of patients
3. Discuss the various types of nursing education programs.
RN, BSN, APRN (masters), PhD (doctoral)
4. Define professional accountability and competence as they relate to nursing practice.
Ability to answer for one's actions. You learn to ensure that your professional actions are
explainable to your patients and your employer. Health care institutions also exercise
accountability by monitoring individual and institutional compliance with national standards
established by agencies such as The Joint Commission (TJC) and the ANA
5. Describe the elements of professional accountability.
Explain the following:
a. Individual Accountability
b. Student Accountability: are liable if their actions cause harm to patients. If a student harms
a patient as a direct result of his or her actions or lack of action, the student, instructor, hospital,
or health
care facility and the university or educational institution generally
share the liability for the
incorrect action.
c. Continuing Competence: continued education
Reading Assignment
Potter, P. A. & Perry, A. G. (2013). Fundamentals of Nursing (8th ed.). St. Louis, MO: Mosby/Elsevier. p. 1-13.
1. Discuss the development of professional nursing roles. Pg 7
Autonomy and accountability: actively collaborate with other health professionals to pursue the
best
treatment plan for a patient
Caregiver: help patients maintain and regain health, manage disease and symptoms, and attain
a maximal
level function and independence
Advocate: protect your patient's human and legal rights and provide assistance in asserting
these rights if
the need arises. As an advocate you act on behalf of your patient and secure your patient's
health care rights and stand up for them
Educator: explain concepts and facts about health, describe the reason for routine care
activities,
demonstrate procedures such as self-care activities, reinforce learning or patient behavior,
and evaluate the patient's progress in learning.

Communicator: allows you to know your patients, including their strengths and weaknesses, and
their needs.
Without it, it is impossible to give comfort and emotional support, give care effectively, make
decisions with patients and families, protect patients from threats to well-being, coordinate
and manage patient care, assist the patient in rehabilitation, or provide patient education.
Manager: establish an environment for collaborative patient-centered care to provide safe,
quality care with
positive patient outcomes.
Career development: Innovations in health care, expanding health care systems and practice
settings, and
the increasing needs of patients have been stimuli for new nursing roles.
Advanced Practice RN: independent functioning nurse. clinical nurse specialist (CNS), certified
nurse practitioner (CNP), certified nurse midwife (CNM), and certified RN anesthetist (CRNA).
2. Describe educational programs available for professional registered nurse education.
RN, BSN, APRN (masters), PhD (doctoral)
3. Describe the roles and career opportunities for nurses.
APRNs, nurse researchers, nurse risk managers, quality improvement nurses, consultants, and
even
business owners.
4. Discuss the influence of social, political, and economic changes on nursing practices. Pg 4
Threat of bioterrorism: educational programs to prepare for nuclear, chemical, or biological
attack. Nurses
are active in disaster preparedness.
Rising costs: Use health care and patient resources wisely
Nursing shortages: resulting in insufficient qualified registered nurses (RNs) to fill vacant
positions and the
loss of qualified RNs to other professions

Institute of Medicine and Robert Woods Johnson Foundation (2011) put forth a vision
Practicing to the full extent of their education and training.
Achieving higher levels of education and training through an improved education system that
provides seamless progression.
Becoming full partners, with physicians and other health care providers, in redesigning the health
care system.
Improving data collection and information infrastructure for effective workforce planning and
policy making.

**POWERPOINT**

TEST 1:
Health Care Systems

Syllabus and blackboard outcomes:

1. Discuss the three levels of prevention and give examples of each level.
1. Primary- prevent disease or injury before it ever occurs. This is done by preventing exposures to
hazards that cause disease or injury, altering unhealthy or unsafe behaviors that can lead to
disease or injury. Education, immunizations.
2. Secondary- reduce the impact of a disease or injury that has already occurred. This is done by
detecting and
treating disease or injury as soon as possible to halt or slow its progress. Exams, screening, low
dose aspirin.
3. Tertiary- soften the impact of an ongoing illness or injury that has lasting effects. Manage and
improve life. Rehab, (diabetes, stroke, asthma, etc) Support groups.
2. List factors that influence the delivery of health care.
Rising costs, increased access to services, a growing population, and improved quality of
outcomes.
3. List different frameworks for delivering care and explain how each they differ, including the advantages
and disadvantages of each.
Functional- one nurse only does one task the entire day
Team- team of members swap duties to complete tasks only on assigned patients
Primary- extended team communicates with one nurse and shes responsible for everything the
patient needs
4. Discuss how Diagnostic Related Grouping (DRG) affects access to health care.
Hospitals receive a set dollar amount for each patient based on the assigned DRG, not based on
length of stay
Textbook:
Giddens, J. F. (2013). Concepts for Nursing Practice. St. Louis, MO: Mosby/Elsevier, Ch. 50
Potter, P. A. & Perry, A. G. (2013). Fundamentals of Nursing (8th Ed.). St. Louis, MO: Mosby/Elsevier, Chapter
2
1. Explain the advantages and disadvantages of managed health care.
2. Discuss the types of settings that provide various health care services.
Preventative Health Care: targeted screening/testing (STD, diabetes, BP, cancer) poisen control,
mental health, community (helmet, seat belts, etc)
Primary health care: family planning, immunization, prevention of locally endemic diseases,
treatment of common diseases or injuries, provision of essential facilities, health education,
provision of food and nutrition
Secondary health care: ED, acute med-surg, (Referred by primary- this is a specialist, like
oncologist,
endocrinologist)
Tertiary health care: Hospitalized, ICU care, subacute
Restorative health care: cardio & spinal rehab, sports medicine, home care
Continued health care: assisted living, psych care, adult day care
Hospice health care: terminally ill, end of life care
3. Discuss the role of nurses in different health care delivery settings.
Health promotion
Illness prevention
wellness

 Primary health care: family dr, NP, dietician, etc

4. Explain the impact of quality and safety initiatives on delivery of health care.
http://journal.ahima.org/2011/08/01/advancing-quality-and-patient-safety-initiatives/
5. Discuss the implications that changes in the health care system have on nursing.
6. Discuss opportunities for nursing within the changing health care delivery system.

TEST 1:
Advocacy and Ethics
**POWERPOINT**
Patient Bill of Rights summarized: http://www.healthsourceglobal.com/docs/Patient%20Bill%20of
%20Rights_merged.pdf
Learning outcomes from syllabus:
1. Discuss the concept of advocacy and how it relates to patient rights.
Support of a particular cause.
2. Discuss the nurses role of advocate.
As a nurse you advocate for the health, safety, and rights of patients, including their right to
privacy.
3. Explain the importance of empowering the patient and methods for implementation. Pg 36
Nurse is the middle man between pt and family, protect pt rights, safety, treated equal, enfore
pt culture/background, communicate for them, emotional support
5. Describe nursing practice that is consistent with the ANA Code of Ethics.
A nurse, in all professional relationships, practices with compassion and respect for the inherent
dignity, worth, and uniqueness of every individual, unrestricted by considerations of social or
economic status, personal attributes, or the nature of health problems.
6. Identify the rights of a patient as outlined in the Patient Bill of Rights.
7. Describe ethical principles in healthcare and apply to various patient situations. Pg 287
Beneficence: taking positive actions to help others
Fidelity: keep promises
Justice: fairness
Advocacy: support of a particular cause
Responsibility: willingness to respect one's professional obligations and follow through on

promises

Accountability: answer for one's actions- take responsibility for actions

Confidentiality: rights and privileges of patients for protection of privacy. HIPAA

NURSING CODE OF ETHICS:

Books
Potter Fundamentals chapter 22
1. Examine and clarify personal values.
The process of values clarification helps you to explore values and feelings and decide how to act
on
personal beliefs and respect values of others, even if they differ from yours.
2. Explain a nursing perspective in ethics.
3. Apply critical thinking to ethical dilemmas.
4. Discuss the role of ethics in professional nursing.
nurses must develop reasoning skills and understand the concepts and principles that

assist ethical analysis.

5. Discuss contemporary ethical issues.

Physican assisted suide

Abortions

Giddens Chapter 38
Deontology: as right or wrong based on their right-making characteristics such as fidelity to promises,
truthfulness, and justice

TEST 1:
Legal
**POWERPOINT**
Learning outcomes from syllabus:
1. Discuss the components of the NC Nurse Practice Act. (minimum acceptable nursing care) ** by
LEGISLATION
Nursing practice Act 9A #7: The practice of nursing by a registered nurse consists of the following ten
components:
a. Assessing the patients physical and mental health including the patients reaction to illnesses
and treatment regimens.
b. Recording and reporting the results of the nursing assessment.
c. Planning, initiating, delivering, and evaluating appropriate nursing acts.
d. Teaching, assigning, delegating to or supervising other personnel in implementing the treatment
regimen.
e. Collaborating with other health care providers in determining the appropriate health care for a
patient but, subject to the provisions of G.S. 90-18.2, not prescribing a medical treatment regimen
or making a medical diagnosis, except under supervision of a licensed physician.
f. Implementing the treatment and pharmaceutical regimen prescribed by any person authorized by
State law to prescribe the regimen.
g. Providing teaching and counseling about the patients health.
h. Reporting and recording the plan for care, nursing care given, and the patients response to that
care.
i. Supervising, teaching, and evaluating those who perform or are preparing to perform nursing
functions and administering nursing programs and nursing services.
j. Providing for the maintenance of safe and effective nursing care, whether rendered directly or
indirectly.
2. Discuss elements of advanced directives and informed consent and the responsibility of the nurse.
Advanced directives- living wills, health care proxies, and durable powers of attorney for health care
Informed consent- legal duty for the health care provider to disclose material facts in terms the
patient is able to understand to make an informed choice
3. Verbalize the legal responsibilities of nursing students.
Have malpractice insurance, practice with integrity, do no harm, truthful about findings, separate
CAN tasks from student tasks
4. Describe the legal responsibilities of nurses regarding HIPAA
Protects private patient information once it has been disclosed in health care settings. Patient
confidentiality is a sacred trust. Nurses help organizations
protect patients rights to
confidentiality

BOOK
Giddens, J. F. (2013). Concepts for Nursing Practice. St. Louis, MO: Mosby/Elsevier, Concept 53


1.
2.
3.

4.

5.
6.

7.

8.

Potter, P. A. & Perry, A. G. (2013). Fundamentals of Nursing (8th ed.). St. Louis, MO:
Mosby/Elsevier, Chapter 23
Explain the legal concept of standard of care.
Discuss the nurses role in witnessing the informed consent process.
Consent means that the patient voluntarily gave consent, the patients signature is authentic,
and the patient appears to be competent to give consent
Describe the legal responsibilities and obligations of nurses regarding the following federal statutes:
Americans with
Disabilities Act (ADA): protects the rights of people with physical or mental disabilities
Emergency Medical Treatment and Active Labor Act (EMTALA): appropriate medical screening
occurs within the capacity of the hospital
Health Insurance Portability and Accountability Act of 1996 (HIPAA): standards regarding
accountability and privacy in the health care setting
Patient Self-Determination Act (PSDA): requires health care institutions to provide written
information to
patients concerning their rights under state law to make decisions
List sources for standards of care for nurses.
American Nurse Association (ANA)
National Student Nurses Association (NSNA)
National League for Nursing (NLN)
North Carolina Nurse Association (NCNA)
Describe the nurses role regarding a do not resuscitate (DNR) order.
If a patient does not have a DNR order, health care providers need to make every effort to
revive the patient.
Define legal aspects of nurse-patient, nursehealth care provider, nurse-nurse, and nurse-employer
relationships.
nurse-patient
nursehealth care provider
nurse-nurse
nurse-employer
List the elements needed to prove negligence.
1. nurse owed a duty to the patient
2. nurse didnt carry out duty or breached it
3. patient was injured
4. patient was injured due to nurse not carry out duty
Describe the nursing implications associated with legal issues that occur in nursing practice.
Torts: civil wrong against person
Unintentional torts: negligence, malpractice
Intentional torts: assault, battery, false imprisionment, privacy invasion
Malpractice: duty, breach of duty, forseeable, causation, injury/harm
Good Samaritian law: encourage healthcare providers to help victims, protects them from liability,
nurse responsible for following through with emergency care

Abandonment and Assignment Issues

Short staffing:

Legal problems occur if there are inadequate nurses to provide care.

Floating:

Based on census load and client acuities

Physicians orders:

Nurses follow orders unless they believe an order is in error or harmful.

TEST 1:
Collaboration
**POWERPOINT** (under notes)
1. Define collaboration.
Teamwork & communication with health care consumer, family, and others in the conduct of
nursing practice.
2. Define collaborative care in nursing practice.
Mental health, behavioral health and substance use services in primary care
3. Discuss key members of the interdisciplinary team.
Helping Hospitalists and Nurses Work Together
4. Understand the concept of chain of command in reporting problems.
Never jump to the highest person on the chain, always talk to the person you have a problem with
first then seek the next highest person in the chain for further advice/help.
5. Explain the essential aspects of collaborative health care
6. Know what type of websites are good to get info from- which ones arent (wikipedia)
The Importance of Collaboration in Nursing.docx
Learning Resources:
Potter, P. A. & Perry, A. G. (2013). Fundamentals of Nursing (8th ed.). St. Louis, MO: Mosby/Elsevier.ch 21
274-285; ch 24 315-319;
1. Describe aspects of critical thinking that are important to the communication process.
2. Describe the five levels of communication and their uses in nursing.
1. W
2. W
3. W
4. W
5. W
3. Describe the basic elements of the communication process.
4. Identify significant features and therapeutic outcomes of nurse-patient helping relationships.
5. Identify a nurse's communication approaches within the four phases of a nurse-patient helping
relationship.
1.
2.
3.
4.
6. Identify significant features and desired outcomes of nursehealth care team member relationships.
7. Describe qualities, behaviors, and communication techniques that affect professional communication.
8. Discuss effective communication techniques for older patients.
9. Identify patient health states that contribute to impaired communication.
10. Discuss nursing care measures for patients with special communication needs.
11. Differentiate among the types of nursing care delivery models.
12. Describe the elements of decentralized decision making.

13. Discuss the ways in which a nurse manager supports staff involvement in a decentralized decisionmaking model.
14. Discuss ways to apply clinical care coordination skills in nursing practice.
15. Discuss principles to follow in the appropriate delegation of patient care activities.
Ignatavicius Unit 1 Ch1 4 &5
Giddens, J. F. (2013). Concepts for nursing practice. St. Louis, MO: Mosby/Elsevier p. 425-433
collaboration ANA/AONE Principles for Collaborative Relationships between Clinical Nurses and Nurse
Managers 3 page

TEST 1:
Evidenced Based Practice
**POWERPOINT**
Upon completion of this module, the student will be able to:
1. Discuss the benefits of evidence-based practice.
2. Describe the five steps of evidence based practice.
3. Explain the levels (hierarchy) of evidence in the literature.
4. Discuss ways to apply evidence in practice.
5. Explain the relationship between evidence practice and performance improvement.
6. Describe the components of a quality improvement program.
Learning Resources:
DiCenso, A. & Cullum, N. (1998, April). Implementing Evidence-based Nursing: Some Misconceptions.
Evidence-Based Nursing, 1(2), p. 38-40. Retrieved from: evidence based practice
Giddens, J. F. (2013). Concepts for Nursing Practice. St. Louis, MO: Mosby/Elsevier, Ch 45, p. 453- 462.
Potter, P. A. & Perry, A. G. (2013). Fundamentals of Nursing (8th ed.). St. Louis, MO: Mosby/Elsevier, Ch 5,
p.50-63
1.
2.
3.
4.
5.
6.
7.
8.

Develop a PICOT question.

Explain the levels of evidence available in the literature.
Discuss ways to apply evidence in practice.
Explain how nursing research improves nursing practice.
Discuss the steps of the research process.
Discuss priorities for nursing research.
Explain the relationship between evidence-based practice and performance improvement.
Describe the components of a quality improvement program.

University of Colorado at Boulder. (n.d.). How do I...? Retrieved from: Evidence based practice
USA library. (n.d.). Criteria for Evaluating the Accuracy/Validity of a Website. Retrieved from evidence
based practice

TEST 1:
Clinical Decision Making
**POWERPOINT**
Learning Outcomes:
1. Describe how the nursing process relates to problem solving, decision making and critical thinking.
Promotes evidence based critical thinking with ADPIE model.
2. Identify and describe the components of the nursing process.

Assessment,diagnosis,planning,implementationandevaluation.

3. Identify and describe the components of a concept map related to the nursing process.
Creates holistic view instead of disease model. Patient info in middle surrounded by objective and
subjective info
4. Develop a concept map applicable to a case study.
5. Develop a nursing care plan applicable to a case study.
6. Know how to make a care plan/concept map
Text books:
Ackley, B. J., & Ladwig, G.B., (2013). Nursing Diagnosis Handbook: An Evidence-based Guide to Planning
Care (10th Ed.) (pp. 1-15). St. Louis, Mo: Mosby/Elsevier.
Giddens, J. F. (2013). Concepts for Nursing Practice (pp. 365-374). St. Louis, MO: Mosby/Elsevier.
Potter, P. A. & Perry, A. G. (2013). Fundamentals of Nursing (8th Ed.) (pp. 192-273). St. Louis, MO:
Mosby/Elsevier.
1. Describe characteristics of a critical thinker.
Interpretation- categorize data
Analysis- open minded
Inference- look for significant info
Evaluate- look at situation objectively
Explanation- support your findings
Self regulation- reflect on your experiences
2. Discuss the nurse's responsibility in making clinical decisions.
Identify clients problem and select appropriate treatment. Know the client and what therapies will
most likely fix the problem.
3. Discuss how reflection improves clinical decision making.
Help you become aware of how you used clinical decision making skills and understand the
experience to develop the ability to apply theory in practice
4. Describe the components of a critical thinking model for clinical decision making.
Knowledge base, experience, critical thinking, competencies, attitudes, standards
5. Discuss critical thinking skills used in nursing practice.
Scientific method, problem solving, decision making, diagnostic reasoning and inference
6. Explain the relationship between clinical experience and critical thinking.

Critical thinking skills for on evaluating alternatives and forming sound judgements, clinical
experiences help support findings
7. Discuss the critical thinking attitudes used in clinical decision making.
Defines how a successful thinker approaches problem, knows when information is misleading, recognizes
own limits
8. Explain how professional standards influence a nurse's clinical decisions.
You must use critical thinking for the good of the person or group. Its a reflection o ethical
standards and promotes highest level of quality care.
9. Discuss the relationship of the nursing process to critical thinking.
Nursing process is a systematic, rational method of planning and providing care by using critical
thinking skills to identify and treat actual/potential health problems and promote wellness. Its a
framework for nurses to be responsible and accountable.

TEST 1:
Health, Wellness & Illness
**POWERPOINT**
Learning Outcomes:
1. Identify historical perspectives on the concepts of health, illness, wellness and disease.
2. Choose definitions of health, wellness and illness from a variety of resources which will guide your
personal and professional behaviors.
3. Describe health indicators and focus areas incorporated in Healthy People 2020.

(1) attain high-quality, longer lives free of preventable disease, disability, injury, and
premature death;
(2) achieve health equity, eliminate disparities, and improve the health of all groups;
(3) create social and physical environments that promote good health for all; and
(4) promote quality of life, healthy development, and healthy behaviors across all life stages

4. Identify evidenced based, professional sources for health care guidelines.

5. Describe the stages of change when an individual is developing a wellness plan. Pg 74
a. Biologic dimensions:
b. Precontemplation: Not intending to make changes within the next 6 months
c. Contemplation: Considering a change within the next 6 months
d. Preperation: Making small changes in preparation for a change in the next month
e. Maintenance: change over time; begins 6 months after action has started and continues

indefinitely
Textbooks
Giddens, J. F. (2013). Concepts for nursing practice. St. Louis, MO: Mosby/Elsevier,Concept 40, p. 406-414
Potter, P. A. & Perry, A. G. (2013). Fundamentals of Nursing (8th Ed.). St. Louis, MO: Mosby/Elsevier. Ch. 6
1. List the two general Healthy People 2020 public health goals for Americans.
1. Increase years of life
2. Improve life quality
2. Discuss the definition of health.
1. state of complete physical, mental, and social well-being, not merely the absence of disease or
infirmity
3. Discuss the health belief, health promotion, basic human needs, and holistic health models to
understand the
* relationship between the patient's attitudes toward health and health practices.
Health belief: understand factors influencing patients perceptions, beliefs, and behavior to plan
care

Health Promotion: routine exercise and good nutrition that help patients maintain or enhance their
present level of health and reduce their risk of developing certain diseases.
Basic human needs: elements that are necessary for human survival and health (e.g., food, water,
safety, and love). (determine persons level of health)
Holistic health: Comprehensive view of the person as a biopsychosocial and spiritual being.
Biopsychosocial:
Spiritual being:
Describe variables influencing health beliefs and practices.
Family practices, socioeconomic factors, and cultural background.
Describe health promotion, wellness, and illness prevention activities.
Illness: immunization programs protect patients from actual or potential threats to health
Wellness: teach people how to care for themselves in a healthy manner.
Health: help patients maintain or enhance their present level of health and reduce their risk of
developing
certain diseases.
Discuss the three levels of preventive care.
Primary: includes health education programs, immunizations, and physical and nutritional fitness
activities.
Secondary: screening, treat early stages, diagnosis, reduce severity to get patient back to normal
level of health
Tertiary: permanent and irreversible state, minimize long term effects, help patient to achieve high
level of
functioning
Describe four types of risk factors. Pg 73
Genetic:
Age:
Environment: where they live
Lifestyle: how they were raised
Discuss risk factor modification and changing health behaviors. Pg 73
Discuss health hazards with the patient following a comprehensive nursing assessment,

4.
5.

6.

7.

7.

then help the patient decide if he or she wants to maintain or improve his or her health
status by taking risk-reduction. Risk-factor modification, health promotion or illness
prevention activities, or any program that attempts to change unhealthy lifestyle
behaviors is a wellness strategy.
9. Describe the impact of illness on the patient and family.
Experience behavioral and emotional changes and changes in roles, body image and self-concept,
and family dynamics.
10. Discuss the nurse's role in health and illness.
Consider the total person and the environment in which the person lives to individualize nursing
care and enhance meaningfulness of the patient's future health status. To help patients identify and
reach health goals, nurses discover and use information about their concepts of health.

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