Nursing 105
Self-Study Help Sheet for Review Purposes
Midterm October 2010
The midterm quiz consists of approximately 22 multiple choice questions, valued at 25% of midterm quiz,
and 5 short answer/short essay questions valued at 75% of midterm. You are required to answer five out
of seven short answer/essay questions. Each short answer is worth 15 points each.
The mid term quiz is worth 30% of final grade in N105. This review document is intended as a guide to
help you organize your study plan for the midterm. The quiz includes content up to and including October
20, 2010. The best way to prepare for the midterm is to quiz yourself about each class objective
contained in your N105 Course Manual.
Faculty teaching N105 hope it is helpful. Remember to review your required readings and notes & PP.
Best wishes for success!
The nursing workforce in Canada
1.
Describe the approximate population of nurses in Canada.
In 2006 there were 207,845 RNs in Canada. With a ratio of 1:129
2.
Where do nurses work? Approximately what proportion of the nursing workforce is employed in
hospitals? Be familiar with different areas of work within the nursing profession today.
59.15 % in hospitals
10.97% in nursing homes
8.41% in community health
2.95% in homecare
2.79% in education
1.99% in physician offices
3.
Define nursing.
Nursing is act and profession of keeping individuals healthy, preventing illness, and
assisting patients when they are ill to a healthy recovery. Nursing is when you assist individuals
to recover to the health status they were before they became Ill and entered the hospital, or to
give them a peaceful death.
Florence Nightingale described nursing as “the act of utilizing the environment of the patient
to assist him in his recovery.”
Virginia Henderson described nursing as “the unique function of the nurse is to assist the
individual, sick or well, in the performance of those activities contributing to health, or it’s
recovery, or to a peaceful death.
Nursing education
4.
Describe how nurses in Canada are educated: What options for education presently exist?
Nurses in Canada are educated by going to university, in a 4 year BScN program. Nursing
graduates have a broad base education. Nurses continue to learn , knowledge expands every 1824 months, The options for education present today are the Baccalaureate level, Master’s level,
and the Doctoral level.
5.
Describe the rationale for the recommendation that nurses obtain a baccalaureate degree for RN
“entry to practice by the year 2000”. Who (which group) originally proposed this recommendation and
why?
Nursing history
6.
Briefly describe how the following nurses contributed to the history of nursing:
a.
Jeanne Mance in 1641 , she came to New France and founded a new hospital, she was
considered the founder of Montreal although people didn’t take kindly to her at first. The Canadian
Nursing Association names the highest honor in her name.
b.
Marguerite d’Youville was the founder of the Grey Nuns ( the sisters of charity ) who were
the first visiting nurses who assisted the poor and visited patients in their homes.
c.
Florence Nightingale established the first independent school of nursing at St.
Thomas hospital in London England. She focused on the standards of nursing care. There was a
dramatic decrease in morbidity and mortality. She valued the importance of hand washing, and
elevated the status of nursing, which allowed women to work outside the home.
d.
Mary Agnes Snively founded the first nurses alumnae association. She also advocated for
the CAN and then became the president.
7.
How did religious orders of nursing sisters contribute to the history of nursing in
Canada? For example, what did the Order of Grey Nuns do?
The grey nuns were the first nurses. They helped the poor and the ill. The Jesuits priests tried
to convert Natives to Christianity.
8.
Trace the evolution of nursing education in Canada since the first nursing school was established.
How were nurses educated in early 20th century Canada? What was the Weir Report? How were
nurses educated in the post-WW2 years?
16th century – Egyptians valued prevention of illness, Greeks developed medicine, Romans
recognized the value of fresh water and Hebrews believed in the spiritual aspect.
17th century – The grey nuns were formed. Women were generally middle class
and
educated.
19th century – Florence Nightingale – improved the standards of nursing; women could work
outside the home. There was decreased morbidity and mortality.
Christian Period – nursing was carried out by women.
Middle Ages – 1100 – 1300 , hospitals were built.
9.
What are the functions of the Canadian Nursing Association (CNA)?
Regulation of nursing as a profession
10. What are the criteria for a profession?
11. Describe how nursing meets these criteria.
12. What is meant by the term “self-regulating profession”? Why is nursing a self-regulated profession?
13. Are nursing professional associations similar to nursing unions? Explain your answer.
Canadian health care system
14. Explain how the following legislative Acts and federal documents affected the evolution of the
Canadian health care system:
a.
British North America Act of Confederation, 1867. This gave the federal and provincial
governments their own jurisdictions. Provinces were responsible for health, education, and social
services, although there was no tax.
b.
Medicare Act the main element of the Social Safety net. The national health insurance
system. Taxes are used to pay for the service. Tommy Douglas is commonly known as the father
of Medicare. Federal and provincial agreed to share health care expenses.
c.
Canada Health Act, 1984 the extra billing was eliminated for Canadian citizens.
d.
The Epp Report, “A framework for health promotion for all Canadians”, 1986
15. Medicare has been one of Canada’s most popular programs, but it is not without problems and
disadvantages. What are some of the advantages and disadvantages?
Some of the problems with Medicare are the wait times (i.e.: knee surgery), access
(traveling), and the health human resources (the distribution of physicians)
16.
Differentiate between voluntary/unpaid; privately-funded; and publicly-funded health care services.
Public: (Medically necessary services), hospital services, physician services
Private: health plans for prescription drugs, semi-private and private hospital
rooms, paramedical practitioners such as chiropractors, physiotherapists ambulance services,
vision care, travel outside of the country, dental benefits, etc
17. Be able to list, briefly describe and give an example of each of the 5 principles enshrined in the
Canada Health Act.
Public Administration- the plan must be administered and operated on a nonprofit basis by a
public authority responsible to provincial & territorial government
Comprehensiveness- include all health services provided by hospitals and physiciansand other
health care professionals where permissible
Universality- all permanent residents receive the insured health care
Portability- coverage for traveling in and outside Canada
Accessibility- reasonable access to services
18. What health services are necessarily covered within the framework of public insurance in the Canada
Health Act, and what services are not necessarily covered?
Hospital services and physician services are covered.
19. What services are commonly covered under private health insurance programs in Canada?
Prescription drugs, private rooms, services such as chiropractors, ambulance services,
vision and dental benefits are covered under the private health insurance
programs.
20. Discuss the roles of the provincial and federal government as it applies to the delivery of health.
Provincial governments were responsible for health, education, and social services.
The
determining organization and laction of hospitals or long term care facilities.
Federal governments were responsible for the administration of principles for the
health
care system (via the CHA). Responsible for financing provinces/territories,
delivers services to
the First Nations.
21. What trends or reforms in health care does “the Romanow report” recommend?
(2002) This report concluded that Medicare is sustainable and to modernize the Canada
Health Act. Some changes included new diagnostic service funding.
22. What are the key highlights of the Kirby report?
(2002) this report concluded that the Medicare system is not sustainable. Move toward private
sector involvement. This included, shift funding from hospitals to service base models, grant
more responsibilities to regional health authorities.
Primary health care
23. Define primary health care & discuss the central purpose and guiding principles. Be able to provide
examples.
Primary health care, is a philosophy and a model for improving health that focuses on
promoting health and preventing illness. It is available to everyone at a cost that all individuals
can afford. It means addressing issues in people’s lives that can make them ill-diet, income,
housing and others. It empowers people to take charge of their own health and to assist with
planning to deliver healthcare in the community. It is considered key to health care reform and
sustainability.
24. How is ‘primary care’ and ‘primary nursing’ different from ‘primary health care’ as defined by the
WHO?
Primary care refers to the first contact the person has with the formal healthcare
system.
Physicians, nurses, dentists, physiotherapists and other health professionals can provide
primary care.
PHC began as a response of the WHO to address the socioeconomic issues that
cause
suffering and death particularly in poor countries.
Nursing research
25. What are the significance/goals of nursing research?
1) Nursing Practice
Study issues such as social, political, environmental factors etc. that affect health
For example: a) look at vulnerable populations
b) develop health promotion strategies
2) Outcomes
Development good measurement processes
Associate with clinical practice
3) Connect Research to Clinical Practice
Develop nursing knowledge
26. What is meant by research/evidence-based practice?
Evidence-Based : Evidenced-informed practice is “ the integration of the most informative
research evidence with evidence from expert clinical practice and other sources to produce the
best possible care for clients” (Potter et al, 2010, p.75).
It provides a safety net for health care professionals to make appropriate decisions within an
acceptable amount of time.
Evidence comes from studies done as experimental or non-experiential such as clinical trials,
consensus, interviews, etc
To ensure that the highest quality of nursing care is given
A sound body of knowledge to support nursing practice
Assists with giving nurses a voice in healthcare to make changes that are best for client care
Research-Based:
1. Quantitative Research-examines nursing issues by measuring and quantifying.
Relationships between variables are explored and theories are developed. Example -descriptive
survey design: measure the rate at which a wound heals
2. Qualitative Research-does not use measurement; instead examines the individual’s
viewpoint. Observation - main way of obtaining data
Examples: Phenomenology-describes the lived experience of a specific fact or event from the
person’s point of view: study the lived experiences of women with breast cancer
Ethnography-observing and describing behavior in varies settings: examine the culture of a
society
27. Discuss the challenges involved in the dissemination and utilization of research findings in nursing
practice.
Health
28. What is health?
Health came from an old English word ‘hoelth’ which means whole of the body
In the past, health was thought of as good physical health. Having good health was the norm and
disease was not considered natural
Pender (2006)- defines health in three ways
1)“Health as stability-Health is defined as the maintenance of physiological, functional, and social
norms, and it relates to concepts of adaptation and homeostasis” (p. 2).
2) Health as Actualization- actualizing human potential
3) Health as actualization and stability-the actualization of human potential through goal-directed
behavior, self-care and good relations with others while making adjustments as needed
29. Approaches to health
1) The Medical Approach:
Western view
predominated the health care system before the 1970’s
medical interventions will restore health
the body similar to a machine in need of repair
focus on diagnostic and therapeutic treatments
many thought that scientific medicine could solve most health problems
2)Behavioral Approach:
the focus of the health care system began after 1974 – (Marc Lalonde Report titled ‘A New
Perspective on the Health of Canadians’. (First Modern Government Document)
huge amounts of money spent on health but health of the population was not improving for the
efforts put into it
shifted the medical approach to a behavioral approach
4 factors identified as affecting health - human biology, environment, lifestyles, health care
organization
lifestyle became the initial focus as it linked health status and personal risk behaviors
3) The Socioeconomic Approach-(Mid 1980s)
focus was on reducing health inequities caused by socioeconomic and environmental factors.
a new conceptualization of health emerged which accounted for the structural influences on
health behaviours; influences such as poverty and appropriate housing for instance. Began to
look at what determines health- the broad the determinants of health and the interrelationships
among them.
Other Notes
Four Pillars of Primary Health Care
•
Teams-health care workers working together to improve continuity of care
•
Access- Canadians should have greater access to health care regardless of where they live
•
Information- sharing and increasing access to information between health care providers and those
who use the health care system.
•
Health Living-recognizes factors outside the health care system such as social, economic and
environmental that affect people’s health.
Eight essentials of primary health care according to the WHO
•
Education about health concerns and methods to avoid or control them
•
Adequate food
•
Safe water supply
•
Adequate sanitation
•
Maternal and child health care
•
Immunization
•
Appropriate care for diseases and injuries
•
Essential drugs
Five principles of primary healthcare
1) Accessibility -….clients have equal access to health services even if they differ by geography, race,
age, gender, language or functional capacity. Ex: Homeless people
2) Health promotion
3) Public participation
4) Appropriate technology
5) Intersectoral collaboration
Nurses Role
•
Be leaders at the political and community level
•
Keep health care reform as a major priority
•
Stay current with present day issues
•
Be familiar with the Romanow, Kirby and Corpus Sanchez reports
•
Improve the health of clients by working through partnerships with the client and agencies in the
community & government
International Council of Nurses
International Council of Nurses and the National Center for Nursing Research in the
united States (1983) saw the need to set priorities for nursing research.
The priorities include: promote in-depth knowledge, recognize nursing research as
essential to nursing practice and education, facilitate cross-cultural research, prepare
nurse researchers, and encourage all national organizations to establish ethical research
standards.
Ottawa Charter
•
Ottawa Charter for Health Promotion- built the framework that has been used to inform population
health and health promotion approaches from a global perspective.
•
Place responsibility of health on society instead of the individual person.
Alma Ata Conference 1978
•
In 1978 at an International conference in Alma Ata, formerly in USSR, representatives from 127
nations and 72 International organizations gathered and committed themselves and their resources to the
achievement of health for all by the year 2000 through ‘primary health care’. The intent was to develop
new solutions and new directions in public health.
•
Health is a fundamental right, an essential element of socioeconomic development. A “grass roots”
approach as opposed to a “top down” approach. Communities throughout the world embraced the
concept of PHC. The conference was significant in the shift in thinking about health.