Unit 1: Nursing as a Profession Dr. Townes • Objectives • Historical and Contemporary Nursing Practice • What is Nursing? Nursing • The International Council of Nurses (2010) captures much of what nursing means in its definition: Nursing encompasses autonomous and collaborative care of individuals of all ages, families, groups, and communities, sick or well in all settings. Nursing includes the promotion of health, prevention of illness, and the care of ill, disabled, and dying people. Advocacy, promotion of a safe environment, research, participation in shaping health policy and in patient and health systems management, and education are also key nursing roles. Nursing Nursing is a profession focused on assisting individuals, families, and communities to attain, recover, and maintain optimum health and function from birth to old age. Nurses act as a bridge Nursing involves a wide range of activities Nursing is a blend of science and art Four broad aims of nursing practice • Promote Health • Prevent Illness • Restore Health • Facilitate coping with disability or death Nursing Aims and Competencies Four broad aims of nursing practice • Promote Health • Prevent Illness • Restore Health • Facilitate coping with disability or death • Four blended competencies: • Cognitive • Technical • Interpersonal • Ethical/legal • Professional Nursing Organizations • Professional: Guidelines for Nursing Practice • • • • • • Nursing Shortage Population based nursing Changing demographic and increased diversity Older and more acutely ill patients Culturally Competent Care Significant advances in nursing science and research Nursing Theories, Philosophy, and the HCC and Conceptual Framework Nursing knowledge Sources of knowledge • Traditional knowledge • Authoritative knowledge • Scientific knowledge Theoretical foundations of nursing practice • Theory • Concepts • Conceptual framework or model • Nursing theory Mississippi nursing competency model Erikson's Developmental Theory Maslow’s Hierarchy of needs Nursing Research • Method of conducting research • Quantitative research method • Qualitative research methods. • Protection of Human Rights • Evidence-Based Practice (EBP) Health care delivery systems & the Health illness continuum Concepts of health and wellness, illness, & disease • • • • Health Wellness Disease Illness Classifications of illness • Acute • Chronic Illness behaviors Factors affecting health and illness Human Dimensions • Physical dimension • Emotional dimension • Intellectual dimension • Environmental dimension • Sociocultural dimension • Spiritual dimension Self-Concept Health Promotion and illness prevention • Health promotion • Illness/disease prevention • The Health Belief Model • The Health Promotion Model Health-Illness Continuum Agent-Host-Environment Model Nursing care to promote health and prevent illness Current focus on health promotion and illness prevention Nurses interventions Care of the nurse Health care delivery systems and the health illness continuum Methods of healthcare delivery Access to health care • Health Insurance Marketplace Quality and safety • Pay for performance • Penalties for readmissions Affordability • Multi-payer system Health Care Reform Healthcare Delivery System and care coordination • Physicians and Hospitals • Fee for service • Multispecialty Group Practices • Community Health Centers • Prepaid Group Practice • Health maintenance organizations (HMOs • Preferred provider organizations (PPOs) • Accountable Care Organizations Paying for Health care • • • • Out of Pocket Payment Individual Private Insurance Employer-based private insurance Government financing • Medicare • Medicaid • Children health insurance program (CHIP) • Veterans Health Administration Health care settings and services • Hospitals • Primary care centers • Ambulatory care centers and clinics • Home health care • Hospital at Home • Extended Care • Specialized Care Centers and Settings • Health Care Services for the Seriously Ill and Dying Collaborative care: The Health care team • • • • • • • • • Physician Physician Assistant Nurse Physical Therapist Occupational Therapist Speech Therapist Social Worker Pharmacist Respiratory Therapist • Dietician • Chaplain/Spiritual Care Provider • Unlicensed Assistive Personnel Trends and issues in health care delivery • Preventative care • Knowledgeable and engaged consumers • Mobile health Nurses’ role in health care reform • Help shape health care for the future • Improving access to care, quality care, and cost of care • Protesting health-related problems • Increasing their education to help the vulnerable population • Promoting health and preventing illness Continuity of Care • • • • Ensures a smooth transition Requires good communication SBAR ISBARQ Admission, discharge and transfer process • Admission to an ambulatory care facility • Admission to the hospital Discharge planning and patient teaching • • • • • Guidelines Assessing and identifying health care needs Setting goals with the patient Meeting eligibility requirements for community-based settings Evaluating discharge planning effectiveness Leaving facility against medical advice • Sign a form • Patient is informed • Witnessed signature
