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Transition To Professional Nursing Practice (NSG421) Exam 4 All Study Guides-1

John Marsh
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Exam 4 All Study Guides-1-ace star model of knowledge transformation

Grand Canyon University

Transition to Professional Nursing Practice (NSG421)

Student Success Session for Exam 4
 Topics
o 11 EBP; page 93, part 4 “Core Competency: Employ EBP”
o 12 Safety; page 97, part 4 “Core Competency: apply quality improvements”
o 13 Informatics and technology; learning IOM Implications of the IOM reports for Nursing Education, part 4 “Core
Competency: Use informatics
o 14 QI and System based practices; Appendices A, B, C and I
o 15 Nursing knowledge; Healthy People 2020
 Research validity and reliability
o Reliability: obtainment of consistent measurements over time
o Validity: the degree that an instrument measures what it is supposed to measure
o These help eliminate biases, make sure data is trustworthy
 Best types of research
o Peer reviewed
o Professional journals within the last 5 years
 What is EBP?
 How is EBP implemented in the clinical setting?
 2 major EBP databases:
o Cochrane Collaborative Library
o Joanna Briggs Institute
 The ACE Star Model
o What is it: used for transforming knowledge to practice in the clinical setting
o It is a model for understanding the cycles, nature and characteristics of knowledge that are utilized in various aspects of
evidence-based practice (EBP)
o It is a depiction of the relationships between various stages of knowledge transformation as it moves into practice
o Recommended by the IOM
o A: academic, C: center, E: evidence based
o Stages: Discovery, evidence summary, translation, integration, evaluation
o Definition of knowledge transformation: the conversion of research findings from primary research results, through a series
of stages and forms, to impact on health outcomes by way of EB care
 Patient-centered care
o Implement patient-centered care by including them in the care
o Learn how they learn best and assess what they know
o Ask the patient for feedback and assess their understanding of their diagnosis and treatment
o When a treatment plan is implemented, it is vital to use the scientific method and reason to determine treatment mechanisms.
Think EBP
o Make sure holistic care is being provided
 Mind, body, spirit
o 6 dimensions of patient centered care
 Respect for patient’s values, preferences and expressed needs
 Coordination and integration of care through collaboration and teamwork
 Accessibility and free flow of information, communication and education
 Physical comfort
 Sensitivity to non-medical and the spiritual dimension of care: emotional support
 Involvement of family and friends
 During transitional care
o Communication SBAR
o Need an order for care transition
 Who are members of healthcare team?
o Patient, their family, PCP, social worker, PT, OT, RT, pharmacist, dietician
o As a bedside nurse you want to work collaboratively to make sure everything is in place
 Especially the physician and case manager
 Safety
o As a new nurse, it is vital to ask questions if unsure of something
o Nurses must know their scope of practice and the policy and procedures in their workplace
 What does the IOM say about safety?
o The IOM says to identify errors and hazards in care, to understand and implement basic safety design principles, continually
understand and measure quality of care in relation to patient and community needs, and design and test interventions to
change processes and systems of care with the objective of improving quality.
 Safety: freedom from accidental injury
 Error: failure of a planned action to be completed as intended or the use of a wrong plan to achieve an aim
 Adverse event: an injury resulting from a medical intervention, not due to patient’s underlying condition. Only a root cause analysis
can determine the relationship of an error to an adverse event
o If it is the result of an error, it is considered a preventable adverse event
 Near miss: recognition that an event occurred that might have led to an adverse event, which provides valuable information for
preventing future actual errors
 How do you promote safety in the hospital according to the IOM?
o Several new studies suggest that patients continue to experience high rates of safety problems during hospital stays
o Nearly one-third of hospital patients experience an adverse event
 Quality care components include structure, process and outcomes.
o Quality care is “providing patients with appropriate services in a technically competent manner, with good communication,
shared decision-making, and cultural sensitivity”
 Number one reason for errors in the hospital: Communication
o Know there are differences between communication errors and system errors
 Joint Commission
o Identifies annual safety standards and goals
o Health care organizations accredited by the JC must strive to meet these goals
 These goals change annually and are aimed to create safe cultures
o Provide accreditation for the healthcare organization to help them meet their standards
o During a survey, they may ask staff about policies and where to find them
o May do random chart inspections to see how nurses are documenting
o Safe medication administration: name and DOB
o What do patient wristbands look like, etc
 Joint Commission Speak Up Campaign
o Reminds patients to speak up when they feel something is wrong
o Helps them identify how patients feel about what errors mean to the patient and families
o Patients are being educated to advocate on their behalf
 Quality improvement outside of hospital setting
o Vaccinations, screenings at health fairs, informing the public of health risks and prevention information, teaching the public
about how they can get access to health care
o Safety outside of hospital
 Safety in their home
 Minimizing fall hazards, making sure batteries are replaced
 Sentinel event: something that causes significant harm or death
o Recommendations occur due to events that lead to a root cause analysis, leading to information that can help implement
accreditation standards and improve patient care
 Why do hospitals want to maintain accreditation?
o They get ROM
o People want to go back to that hospital for care
 Informatics
o How we receive information and document patient care
o Helps us communicate with other health care staff
o We have to make sure it doesn’t hinder personal care
 How do you stay current on EBP
o Nursing journals, continuing education



Transition To Professional Nursing Practice (NSG421) Exam 4 All Study Guides-1

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