Questions and Answers
What are the steps in the decision-making process?
C-I-D-E: Consider alternatives, Identify best choice, Develop a plan, Evaluate decision.
What is regulated by laws in nursing practice?
Who develops standards of care in nursing?
What do licensure requirements include?
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What might cause the state board of nursing to revoke or suspend a license?
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What defines intentional torts?
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What is negligence in nursing?
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What are the elements of malpractice?
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What are components of informed consent?
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What is the purpose of a code of ethics in nursing?
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What are the six pillars of character?
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How does HIPAA relate to patient privacy?
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What is telehealth?
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What is telehealth?
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Which of the following are benefits to the patient with telehealth? (Select all that apply)
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What are overall benefits of telehealth? (Select all that apply)
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Which of the following technologies are used in telehealth? (Select all that apply)
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What is telenursing?
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What is the definition of violence according to the National Institute for Occupational Safety and Health?
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What factors promote tele-nursing? (Select all that apply)
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What are non-monetary benefits of telehealth? (Select all that apply)
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What is the prime reason why nurses are leaving the profession?
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What should effective tele-nursing do?
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Nurses rank just after police and firefighters for rates of injury and death on the job.
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What are the advantages of tele-nursing? (Select all that apply)
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What is the ratio of violence against nurses to non-nurses in the healthcare setting?
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Which type of violence in healthcare involves a customer or client on worker violence?
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What are two risk factors for violence in the hospital?
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Match the types of violence to their descriptions.
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The recommended NIOSH strategies for violence prevention include ______.
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Which of the following is a legal issue surrounding workplace violence?
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What is suggested for preventing workplace violence?
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What percentage of nurses have experienced bullying during their career?
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What should a nurse do if bullying happens to them?
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What is critical thinking?
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What is one step in the decision-making process?
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Study Notes
Violence Against Nurses
- Nurses face high rates of injury and death in the workplace, ranking just behind police and firefighters.
- Workplace violence is a primary factor driving nurses away from the profession and includes physical and psychological harm.
- Most violence against nurses originates from customers, clients, or patients, including threats and physical assaults.
Definitions of Violence
- The National Institute for Occupational Safety and Health (NIOSH) defines workplace violence as physical assault, threatening behavior, or verbal abuse in work settings.
- The World Health Organization (WHO) defines violence as incidents where staff are abused or threatened in relation to their job.
Violence Statistics
- Ratio of violence against nurses in healthcare is 2:1 compared to non-nurses.
- Nurses are at the highest risk of workplace violence, with a homicide rate of 130 cases in healthcare from 1997 to 2009.
- Assault rates for health care and social workers were 8.2 incidents per 10,000 full-time workers; nursing had a much higher rate of 20.4.
Types of Criminal Intent
- Type 1 involves perpetrators with no legitimate relationship to the business, committing crimes along with violence.
- Type 2 is the most common in healthcare settings, where clients or patients inflict violence, especially in emergency and psychiatric contexts.
- Type 3 describes lateral violence among workers, often manifesting as bullying or emotional abuse.
- Type 4 involves personal relationships spilling into the workplace, impacting nurses' safety.
Common Areas for Violence
- High-risk areas for violence include psychiatric wards, emergency rooms, waiting rooms, and geriatric units.
Risk Factors for Workplace Violence
- Factors vary by facility and include understaffing, volatile individuals, inadequate training, and poor environmental design.
- Long wait times and unrestricted public access increase violence risks.
- Assault may occur when services are denied or during high-interaction times like meal and visiting hours.
Regulatory Background and Risk Management
- Key organizations: NIOSH and OSHA provide guidelines for workplace safety and violence prevention.
- Risk management focuses on protecting organizational assets from loss, emphasizing preventive measures.
Violence Prevention Strategies
- NIOSH recommends strategies that include environmental design, administrative controls, and behavior modifications.
- Administrative controls may involve staffing patterns and restricted public access.
- Behavior modifications focus on conflict resolution and maintaining situational awareness.
Measures for Violence Prevention
- Important preventive measures include installing security systems, improving lighting, and providing escorts in parking areas.
Legal Issues and Safe Work Environments
- Employers could face higher workers' compensation rates and potential negligence claims regarding security and staff safety.
- Recommendations for safe work environments include emergency alarms, metal detectors, and well-designed patient areas.
Bullying and Lateral Violence
- Approximately 80% of nurses report experiencing bullying during their careers, often from higher authority figures.
- Bullying negatively impacts retention, with nearly 60% of new nurses leaving their positions within six months due to workplace violence.
Consequences of Bullying
- Bullying leads to health declines, increased sick days, and even suicide in extreme cases.
- Consequences include decreased work satisfaction and increased patient care costs.
Critical Thinking in Nursing
- Critical thinking involves disciplined reasoning to make informed decisions, particularly in clinical settings.
- Skills include interpretation, analysis, evaluation, explanation, and self-regulation, crucial for safe nursing practice.
Decision Making Process
- The DECIDE model outlines the decision-making process: Define the problem, Establish criteria, Consider alternatives, Identify the best choice, Develop an action plan, and Evaluate outcomes.
Importance of Open Communication
- Encouraging open communication and regular feedback among staff is essential for creating a supportive and safe work environment.
Emotional Support and Employee Assistance Programs
- Employee Assistance Programs provide support to help staff cope with workplace stressors, and counseling can be critical for both victims and aggressors.### Regulation of Nursing Practice
- Governed by various laws including New York State Nurse Practice Act, Patient Self-Determination Act (PSDA), HIPAA, ADA, Medicaid Statutes, Public Health Laws.
- Standards of care are established by organizations such as ANA, state boards, healthcare institutions, procedural textbooks, and nursing policies mandated by JCAHO.
Licensure of Nursing Practice
- Requirements established by state boards include educational qualifications, passing the NCLEX exam, maintenance and renewal protocols, suspension, revocation processes, and professional misconduct proceedings.
Reasons for License Revocation or Suspension
- Common reasons include drug/alcohol abuse, fraud during the licensing process, felony convictions, negligence, previous disciplinary actions in other states, physical/mental impairments, and practicing with an expired license.
Criminal Action vs. Civil Action
- Criminal actions are offenses against individuals and society, subject to punishment by imprisonment, categorized as felonies or misdemeanors.
- Civil actions (torts) involve wrongs against individual rights or property, typically resolved through monetary compensation, can also include criminal elements leading to trials in both types of courts.
Torts
- Intentional Torts: Include fraud, invasion of privacy, defamation (slander and libel), assault (threat) and battery (actual physical harm).
- Unintentional Torts: Primarily negligence, which involves omission (failure to act) and commission (acting against standards), distinguishing malpractice as professional negligence.
Elements of Malpractice
- Must establish four elements: Duty (responsibility to care), Breach of Duty (failure to meet standards), Injury (harm caused), and Proximate Cause (link between action and harm).
Protecting Yourself as a Nurse
- Practice safely, establish caring patient relationships, document thoroughly, be aware of contractual obligations, and carry liability insurance.
- Understand responsibilities under Good Samaritan Laws.
Informed Consent
- Requires explanation of procedures, risks, and alternatives; patients must be competent and of legal age to consent or refuse. Physicians obtain consent, while nurses ensure patients are informed.
Values, Morals, and Ethics
- Values define what is important to individuals, while morals relate to personal motivations. Ethics embodies internally defined principles guiding professional conduct.
Six Pillars of Character
- Respect, trust, fairness, citizenship, responsibility, and caring form the foundation of character in practice.
Code of Ethics
- Outlines ethical obligations and duties of nurses, expressing non-negotiable standards and commitment to society through nine provisions addressing fundamental values, duty boundaries, and beyond individual patient encounters.
ANA Provisions
- Emphasize compassion, patient commitment, advocacy for patient rights, accountability, responsibility for personal and professional growth, and collaboration in health policy.
Ethics Committees
- Function to facilitate understanding of ethical issues among involved parties without authority to make final decisions, aiding in conflict resolution.
Ethical Principles
- Include Autonomy, Nonmaleficence, Beneficence, Justice, and Fidelity, which should guide decision-making in ethical dilemmas.
All-Hazards Disaster Preparedness
- Establishes flexible action plans for various types of disasters, emphasizing the CNO's role in forming oversight committees.
Nursing Informatics
- Integrates nursing science, computer science, and information science, supporting decision-making through effective management of data and information.
Impact of Technology on Healthcare
- Enhances patient safety and care quality, improves operational efficiency, decreases errors, facilitates patient empowerment, and creates better care environments.
Competencies in Informatics
- Healthcare professionals should be proficient in word processing, electronic data management, security awareness, and enhancing patient access to health information.
Standardized Terminology
- Acknowledges the need for a common language among providers for effective communication and collaboration.
Nanotechnology Applications
- Includes monitoring drug levels, targeted chemotherapy delivery, and advanced monitoring devices, potentially transforming disease treatment and monitoring.
Telehealth
- Utilizes telecommunications to deliver healthcare at a distance, offering improved access, faster diagnoses, reduced costs, and better patient outcomes.
Telenursing
- Focuses on remote nursing care through IT, addressing nursing responsibilities and facilitating interaction with patients at a distance.
Benefits of Telehealth
- Encompass improved patient experiences, higher satisfaction, self-management empowerment, enhanced access to services, and overall cost savings.
Effective Tele-nursing Practices
- Must include client education, collaboration with healthcare teams, competence in technology use, adherence to consent policies, confidentiality, and evidence-based practice enhancements.
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Description
This quiz focuses on the critical issue of workplace violence faced by nurses. It covers definitions and statistics related to injuries and threats that nurses experience on the job. Understand the factors contributing to this alarming trend and its impact on the nursing profession.
