Fundamentals of Nursing Exam 1 Review PDF

Fundamentals of Nursing Exam I Review Chapter 1 1. Nursing as a profession a. Nurses work together to take care of individuals b. Nurses optimize patients and familial health and wellbeing c. Core values i. Dignity...

Fundamentals of Nursing Exam I Review Chapter 1 1. Nursing as a profession a. Nurses work together to take care of individuals b. Nurses optimize patients and familial health and wellbeing c. Core values i. Dignity ii. Integrity iii. Autonomy iv. altruism v. Social justice 2. ANA- American Nursing Association a. Develops, revises, and maintains the scope of practice statement and standards that apply to the practice of all professional nurses 3. Human dignity a. People hold special value that is tied to their humanity b. Nothing to do with race, class, age etc. c. Having respect for each human individuality 4. Integrity- a. Quality of being honest and fair b. Possessing high moral principles 5. Autonomy a. Intuitive nursing, being able to put skills to practice b. Being able to work independently c. Professionally with self determination 6. Altruism a. Empathy for patients, other nurses, and healthcare providers b. The ability to speak up on their behalf 7. Social Justice a. Equal rights for everyone b. The right to good health, and equal opportunity to obtain that health 8. Science and Art of Nursing Practice a. Requires i. Current knowledge and practice standards ii. Critical thinking iii. Compassionate approach b. Care must i. Meet patients’ needs ii. Meets the needs and values of society and professional standards iii. Integrate evidence – based findings to provide the highest level of care iv. Essential that you socialize within the profession and make connections 9. Science and Art of Nursing Practice a. Benners stages of nursing practice i. Novice-  1. beginning nursing student, linear and stepwise rules ii. Advanced beginner- 1. a nurse who has had some level of experience, able to identify meaningful aspect iii. Competent- 1. A nurse in the same position for 2-3 years. Is able to proficiently move through the steps of the practice iv. Proficient- 1. A nurse in the same position for more than 2-3 years. Focuses on patient care, and is able to rely on past experiences v. Expert- 1. Is able to identify issue and quickly resolve them. Is intuitive and is adequately able to resolve problems from every dimension. Many years 10. Standards of Practice a. Competent level of nursing care demonstrated by a critical thinking model known as the nursing process 11. The Nursing Process (ANA standards)- critical thinking model a. Assessment i. Collects pertinent data and info relative to healthcare b. Diagnosis i. Analyzes the assessment data to determine the actual or potential diagnosis, problems and issues c. Outcomes identification i. Identifies expected outcomes for a plan individualized to the patient d. Planning i. Develops plan encompassing strategies to achieve expected outcomes  e. Implementation i. Registered nurse implements the identified plan 1. Coordination of care a. Coordinates care delivery 2. Health teaching and health promotion a. The registered nurse employs strategies to teach and promote health f. Evaluation i. Evaluates progress toward attainment of goals and outcomes 12. Code of ethics a. Philosophical ideals of right and wrong that define principles used to provide care b. Incorporate your own values and ethics 13. Professional Rolls a. Autonomy- i. Initiation of independent nursing interventions without medical orders b. Accountability i. Full responsibility for the type and quality of care, whether dependent, independent, or interdependent c. Caregiver- i. Assist patients to reach the optimum level of health and independence d. Advocate- i. Patient advocate, someone whose goal is to protect the right of your patients e. Educator  i. Being able to inform your patients as to further meet their personal needs f. Communicator i. Central role of the professional nurse ii. Allows you to know your patients, including their preferences, strengths, weaknesses, and needs g. Manager- i. Establish an environment for providing collaborative, and safe patient- centered care with positive outcomes 14. Career Development Career path Definition Clinician Classic, Hands-on nurses Advanced Practice Registered Nurse (APRN) MOST INDEPENDENT, masters or doctorate in nursing Clinical Nurse Specialist APRN in a specialized area of practice Nurse Practitioner APRN, that provides primary, acute, and specialty health care Certified Nurse-midwife APRN, Work with women Certified Registered Nurse Anesthetist APRN, advanced education in anesthesia. Needs 1 year of critical care experience Nurse Educator Teaches nurses Nurse Administrator Manages nursing staff and health care agency Nurse Researcher Work to improve, and research, nursing care 15. Florence Nightingale a. Developed the first organized program for training nurses b. First practicing nurse epidemiologist c. Connected poor sanitation with dysentery and cholera d. Improved sanitation in hospitals e. Practices are a basic part of nursing today 16. Magnet designed organization a. Magnet recognition program – nurses align goals, provides a road map for education 17. Changing needs of society a. Aging pop b. Cultural diversity c. Bioterrorism d. Emerging infections e. Disaster management 18. Influences that effect nursing a. Importance of self-care i. Nurses have physical and emotional demands ii. Prevent burnout and compassion fatigue b. Health care reform i. Affects how health care is paid for and delivered c. Demographic changes i. These will require expanded healthcare resources  d. Medically underserved i. Nurses are advocates for the medically underserved population ii. This population is growing 19. Trends in Nursing a. Evidence- Based practice i. Clinical judgment that is influence by the critical thinking element of knowledge, which in turn helps shape clinical judgment b. Quality and Safety Education for Nurses (QSEN) i. Prepares future nurses and advanced practice nurses to have the knowledge, skills, and attitudes necessary to continuously improve the quality and safety of the health care systems within which they work c. Impact of emerging technologies- i. Technology provides more accurate- noninvasive assessment tools ii. Helps you 1. implement evidence-based practices automatically 2. Collect and trend patient outcome data 3. And use clinical decision support systems d. Genomics i. Study of inheritance or the way genes are passed ii. This information mixed with new technologies can improve health outcomes, quality, and safety and reduce health care cost e. Impact of Nursing on Politics and Health policy i. Nurses’ involvement in politics works to improve healthcare for all ii. Ex ANA, State Boards of Nursing ext.. 20. Professional Nursing Organizations a. Deal with the issues of concern to those practicing in the profession  b. National League for Nursing (NLN) c. American Nurses Association (ANA) d. International Council for Nursing (ICN) e. National Student Nurses Association (NSNA) Chapter 2 Health care Associations Function Managed Care organization (MCO) Family Care program that coordinates service Preferred Provider Organization (PPO) Network of health service Medicare Insurance for elderly (65+) / disabled Medicaid Insurance for the poor State Children’s Health Insurance Program Insurance for children (SCHIP) Patient Protection and Affordable Care Act Makes health insurance available to more (ACA) Obama care people, lowers bar of acceptance 1. Population wellness a. Shift from managing illness to managing health of a community and environment i. Rather than finding cure for individual disease 2. Health service pyramid  a. 3. Primary care/ preventative care a. preventive care i. Reduces and controls risk factors for disease b. Primary care i. Focuses on improved health outcomes ii. Ex. Family practitioner c. Health promotion programs lower overall cost i. Reduce incidence of disease ii. Minimizes complications iii. Reduce the need for more expensive resources 4. Secondary and Tertiary Care a. Acute Care settings i. Secondary 1. Hospital in-patient care  2. Specialty, sent by primary 3. Ex. Cardiologist ii. Tertiary 1. Hospital critical care unit 2. Specialty, sent by secondary 3. Ex. Sent to Cardiac surgeon by cardiologist b. Includes hospital emergency departments, urgent care centers, critical care units, inpatient medical-surgical units 5. Population wellness a. Restorative care i. Home health ii. Rehabilitation iii. Extended/intermediate/skilled care b. Continuing care i. For individuals who are disabled or functionally dependent or suffering a terminal illness 1. Hospice 6. Nursing shortage a. Expected to intensify as baby boomers grow old b. Nursing schools are struggling to expand their capacity 7. Healthcare issues a. Nursing shortage b. Quality and safety (QSEN) i. Safety is a Vital aspect of quality health care  ii. QSEN helps nurses to identify and bridge the gaps between what is and what should be iii. Goal is to prepare nurses with knowledge, skills and attitudes necessary for the job c. Magnet Hospital Status i. Basically, a status symbol for hospitals ii. Nursing delivers excellent patient outcomes iii. Nurses have high level of job satisfaction, and where there is a low staff nurse turnover rate and appropriate grievance resolution. iv. Indicates nursing involvement in data collection and decision-making in-patient care delivery d. Informatics i. Use technology communicate, manage knowledge, mitigate errors, and support decision making e. Globalization of health care- the spread of health care ideals and practices Chapter 5 1. Evidence-Based Practice- a. Combining own knowledge with patient condition and literature. b. Best available research evidence c. Clients’ characteristics, state, needs, values, preferences d. Resources including practitioner expertise e. Environment and organizational context f. Best scientific evidence is found in i. Scientific peer-reviewed journals 2. Evidence based practice importance- a. problem solving approach b. Improve quality, safety, patient outcomes, and nurse satisfaction while reducing cost c. Assist in effective, timely, and appropriate clinical decisions i. in response to the broad political, professional and societal forces present in today’s health care d. Don’t go by the status quo 3. Best most relevant, current and accurate information- no older than 5 years a. Textbooks b. Articles from nursing and health care lit c. Quality improvement and risk management data d. Standards of care e. Infection control data f. Benchmarking, retrospective or concurrent chart reviews g. Clinicians’ expertise 4. Stages of Evidence-Based Practice a. Cultivate a spirit of inquiry b. Ask a Clinical question in PICOT format c. Search for Best evidence d. Critically appraise the evidence e. Integrate the evidence f. Evaluate the outcomes of practice decision or changes g. Communicate the outcomes of the EBP decision  5. Cultivate a spirit of inquiry a. Question what does not make sense to you and what needs to be clarified i. Then develop a specific question 6. Ask a clinical question in PICOT format a. PICOT can help formulate a well-defined searchable question b. A well designed EBP question does not have to follow the sequence PICOT Meaning Patient, Population or Problem Identification, who is being discussed Intervention What treatment/intervention is being considered Comparison What is it alternatively being compared to Outcome What is the outcome, what are you looking to achieve Time What amount of time is needed for an intervention to achieve the outcome 7. Search for the best evidence 8. Critically appraise the evidence a. After critiquing all articles for a PICOT question i. Synthesize or combine the findings ii. Consider the scientific rigor of the evidence and whether it has application in practice b. Use a systematic approach i. Determine the value, feasibility and usefulness of the evidence 9. Integrate the evidence a. Apply the research in your plan of care for a patient; use evidence as rationale b. Education about the change must occur c. Large-scale change requires planning  d. Pilot study can show if change can be implemented easily e. Incorporate into policies and procedures f. Integration: i. Teaching tools, clinical practice guidelines, P&Ps, new assessment tools 10. Evaluate the outcomes of practice decision of changes a. When evaluation an evidence -based practice change determine i. Was the change effective ii. Are modifications needed iii. Should the change be discontinued b. Unexpected events or results may occur c. Never implement a practice change without evaluation its effects 11. Communicate the outcomes of the evidence-based practice decision a. If you implement an evidence-based intervention with one patient, you and the patient determine the effectiveness of that intervention b. Share results with various groups of nurses or other care providers 12. Sustain knowledge use a. Incorporate the change into the culture and practice environment b. Used target strategies c. Employ transformational leadership 13. Nursing interventions must be tested through research to determine the measures that work best with specific patients  i. 14. Scientific Method a. Minimizes a researcher’s bias b. Steps i. Make an observation ii. Ask questions/gather info iii. Analyze literature and form a research question or hypothesis iv. Conduct a study using scientific rigor v. Analyze the date and draw conclusions 15. Types of research a. Quantitative research i. The precise, systematic, objective examination of specific concepts ii. Focus on numerical data, statistical analysis, and controls to eliminate bias in findings iii. Experimental research 1. Tightly controls conditions to eliminate bias with the goal of generalizing the results of the study to similar groups of subjects iv. Nonexperimental research 1. Describe, explain or predict phenomena v. Surveys 1. Obtain information regarding the frequency, distribution, and interrelation of variables among subjects in the study  2. Sampling errors need to be minimized a. Sampling error i. Sample does not represent the entire pop under the study b. Qualitative research i. Studies phenomena that are difficult to quantify or categorize 1. E.g., Perception of illness, or quality of life ii. Inductive reasoning 1. Helps to develop generalizations or theories from specific observations or interviews 16. Nursing research a. A way to identify knowledge and improve practice b. Advances nursing science c. Obtain consent and assure privacy/confidentiality d. Translation research phases i. Focuses on testing implementation interventions to improve uptake and use of evidence to improve patient outcomes and population health Translation Research Phases Preclinical and Animal Studies Basic science research, sometimes on animals Phase 1 Clinical Trials Testing safety and efficacy in a small group of people Phase 2 and 3 Clinical Trials Testing safety and efficacy in a larger group. Testing for comparison to standard treatment Phase 4 Clinical Trials and Outcomes Translation to practice Research Phase 5 Population Level and Outcomes Translation to community Research e. Outcomes Research i. Helps patients, health providers, and those in health care policy make informed decisions on the basis of current evidence ii. Typically focuses on the benefits, risks, costs, and holistic effects of a treatment on patients iii. Must be observable and measurable iv. Need select appropriate outcomes when designing their studies Chapter 6 1. Healthy people a. Provides evidence-based, 10-year national objectives for promoting health and preventing disease 2. Healthy people 2030 a. Provides a society in which all people live long, healthy lives b. Identifies leading health indicators which are high-priority health issues in the United States 3. Definition of Health a. A state of complete physical, mental and social well-being, not merely the absence of disease or infirmity ~ WHO b. A state of being that people define in relation to their own value personality and lifestyle 4. Models of Health and Illness a. Models help explain complex concepts or ideas  i. Health and illness b. Health beliefs i. A person’s ideas, convictions, and attitudes about health and illness ii. Can be based on 1. reality or false expectations 2. facts or misinformation 3. good or bad experiences iii. Can influence health positively or negatively 1. Positive health behaviors a. Maintain, attain or regain health and prevent illness b. Ex. Well rounded diet, exercise, sleep etc.… 2. Negative health behaviors a. Practices that are harmful to health b. Ex. Crap diet, no exercise, substance abuse 5. Health belief model a. Addresses the relationship between a person’s beliefs and behaviors b. Helps understand factors influencing patients’ perceptions, beliefs, and behaviors to plan care so that you can more effectively help patients maintain or restore health and prevent illness c. First component i. Individual perception of susceptibility to an illness d. Second component i. Individuals’ perception of seriousness of the illness e. Third component i. Likelihood that a person will take preventive action 6. Health Promotion Model a. Defines health as a positive, dynamic state, not merely the absence of disease b. Describes the multidimensional nature of people as they interact with their environment to pursue health c. Three main foci i. Individual characteristics and experiences ii. Behavior specific cognitions and affect iii. Behavioral outcome- in which the patient commits to or changes a behavior 7. Models of health and Illness a. Maslow’s Hierarchy of Needs i. Used to understand the interrelationships of human needs 1. Food, water, safety, love  b. Holistic health model i. Considers emotional, spiritual, social, cultural and physical aspects of wellness ii. Empowers patients to engage in their own recover and assume some responsibility for health maintenance iii. Ex. Meditation 8. Variables influencing Health and Health beliefs and practices a. Internal variables i. Developmental stage 1. Growth/emotional development ii. Intellectual background 1. Intelligence iii. Perception of functioning 1. The way a patient perceives physical functioning iv. Emotional factors 1. Degree of stress, depression, or fear  v. Spiritual factors 1. Values and beliefs, ability to find hope b. External variables i. Family role and practices ii. Social determinants of health 1. Circumstances and environment iii. Culture 1. Influences beliefs, values, and customs 9. Health Promotion, Wellness, and Illness Prevention a. Health promotion i. Helps individuals maintain or enhance their present health b. Health education i. Helps people develop a greater understanding of their health and how to better manage their health risks c. Illness prevention i. Protects people from actual or potential threats to health 10. Three Levels of Prevention Three Levels of Prevention Primary Prevention Reduces incidence of disease, BEFORE it happens Secondary Prevention Prevents the spread, AFTER it occurs Tertiary prevention Minimizes the effects of long-term disease or disability 11. Risk Factors  a. Any attribute, quality, environmental situation, or trait that increases the vulnerability of an individual or group to an illness or accident b. Rick factors include i. Nonmodifiable risk factors 1. Factors that cannot be changed, like age, gender, genetics, and family history ii. Modifiable risk factors 1. Factors that can be modified, like smoking, drinking alcohol, unhealthy diet, obesity etc.… iii. Environmental 1. Where we live and the condition of that area 12. Risk Factor Identification and changing Health Behaviors a. Identify risk factors i. Assessment 1. Will help identify modifiable and nonmodifiable risk factors ii. Health risk appraisal forms 1. Help identify health threats based on the presence of various risk factors b. Implement education and counseling i. Wellness strategies c. Understand the stages of change i. Transtheoretical Model of Change Transtheoretical Model of Change Precontemplation No intent, within next 6 months Contemplation Considering change, within next 6 months Preparation Making small changes, in prep for a change Action Actively engaged in change Maintenance Sustaining change 13. Illness a. A state in which a person’s physical, emotional, intellectual, social, developmental, or spiritual functioning is diminished or impaired b. Acute illness i. Short duration and severe c. Chronic illness i. Last longer than 6 months ii. Affects functioning d. Illness behavior i. Involves how people monitor their bodies and define and interpret their symptoms e. Variables influencing illness and illness behavior i. Internal variables 1. Patients’ perceptions of symptoms and the nature of a disease a. Coping skills and locus control (degree to which people believe they control what happens to them) ii. External variables 1. Visibility of patient’s symptoms a. Person with fever is more likely to go to hospital f. Impact of illness on the patient and family i. Behavioral and emotional changes 1. Short-term illness a. More subtle  2. Long term illness a. Lead to more drastic emotional and behavioral changes 3. Ex. Anger, sadness ii. Impact on body image 1. Profound change a. Generally, adjusts through grieving b. Ex. Mastectomy effect on body image iii. Impact on self-concept 1. How you view yourself iv. Impact on family roles 1. Ex. Son having to care for an ill father/mother v. Impact on family dynamics 1. Ex. Bread winner ill, other members of family have to step up 14. Caring for yourself a. Eating nutritious diet b. Get adequate sleep c. Engaging in exercise and relaxation activities d. Establishing a good world-family balance e. Engage in regular nonwork activities f. develop coping skills g. allowing personal time for grieving h. focus on spiritual health i. find a mentor Chapter 7 1. The American Organization of Nurse Executives  a. AONE b. Describes caring and knowledge as the core of nursing i. With care being a key component of what a nurse brings to a patient experience 2. Theoretical views on caring Theoretical views on caring Caring is primary Caring is the essence of excellent nursing practice Leininger’s Transcultural caring Caring involves many cultures. Even though caring is a universal phenomenon, the expressions, processes and patterns of caring very among people of different cultures. Thus, caring differs between patients, and the nurses need to learn culturally specific behaviors and words that reflect caring. Watson’s Transpersonal caring The nurse’s conscious intention to interact with patients, reflect caring, and promote healing and wholeness. Care before cure Swanson’s Theory of caring Caring is the nurturing way of relating to the individual 3. Summary of theoretical views a. Nursing caring theories have common themes i. Caring is highly relational ii. It is obvious when caring is absent iii. Enabling is an aspect of caring iv. Knowing the context of a patient’s illness helps you choose and individualize interventions that will actually help the patient b. Patient perspective i. Patients value the affective dimension of nursing care  1. Caring assessment tool a. Measures patients’ perceptions of caring 2. When patients sense that health care providers are sensitive, sympathetic, companionate and interested in them as people, they usually become active partners in the plan of care 3. Assess what your patient expects 4. Build a nurse-patient relationship to learn what is important to your patients 5. When patients sense that health care providers are attentive to them as people, they become active partners in the plan of care 6. Patients and nurses often differ in their perception of care 7. Focus on building a relationship that allows you to learn what is important to your patients 8. Knowing your patients helps you select caring approaches that are most appropriate to their needs 4. Provide a. Presence i. Person-to person encounter conveying a closeness and a sense of caring ii. Involves “being there” and “being with” iii. Being there 1. Physical presence along with communication and understanding iv. Being with 1. Giving himself, which means being available and at the patient’s disposal Swansons Theory of Caring Knowing Striving to understand an event as it has meaning in the life of the other Being with Being emotionally present to the other Doing for Doing for the other as one would do for self if it were at all possible Enabling Facilitating the others passage through life transitions and unfamiliar events Maintaining belief Sustaining faith in the others capacity to get through an even or transition and face a future with meaning v. Nursing presence is the connectedness between a nurse and a patient 1. Strengthens ability to provide effective patient-centered care b. Touch i. Provides comfort ii. Creates connection iii. Types of touch 1. Noncontact touch 2. Contact touch- physically touching 3. Task-oriented touch- touching for a procedure 4. Caring touch- touching to comfort 5. Protective touch- ex. Preventing an accident 6. Therapeutic touch- holistic, alternative medicine c. Listening i. Necessary for meaningful interaction ii. True listening leads to knowing and responding to what really matters to a patient and family iii. To listen effectively you need to silence yourself iv. Listen with an open mind v. Through active listening you begin to truly know your patients and what is important to them d. Knowing the patient  i. The core of clinical decision making and patient-centered care ii. Two elements that facilitate knowing are continuity of care and clinical expertise iii. Factors of knowing include 1. Time 2. Continuity of care- (ex. having the same patients a few days in a row) 3. Teamwork of nursing staff 4. Trust 5. experience e. Spiritual care- i. Balance between life values, goals, and belief symptoms and those of others ii. Offers a sense of intrapersonal, interpersonal and transpersonal connectedness Types of Connectedness Intrapersonal Connected with one’s self Interpersonal Connected with others and the environment Transpersonal Relationship exists when one is connected with God, an unseen force, or a higher power f. family care- i. involving one’s family is important to providing quality care ii. Challenges 1. Task-oriented biomedical model 2. Institution demands 3. Time constraints 4. Reliance on technology 5. Cost-effective strategies  6. Standardized work processes Chapter 9 1. Culture- a. Learned and shared beliefs, values, norms, and traditions of a particular group, which guide our thinking, decisions, and actions 2. Unconscious bias a. Bias we are unaware of i. happens outside our control ii. influenced by our personal background, cultural environment, and personal experiences 3. Culturally congruent care a. Emphasizes the need to provide care based on an individual’s cultural beliefs, practices, and values b. Helps you engage a patient and family in respectful, patient-centered dialogue 4. Cultural competence a. Professional health care must be culturally sensitive, culturally appropriate, and culturally competent to meet the multifaceted health care needs of each person, family, and community 5. World View a. Emic World view i. Insider perspective b. Etic World view i. Outsider perspective  c. Stereotype i. An assumed belief regarding a particular group ii. AVOID STEREOTYPING iii. Approach each person individually 6. Health Disparities a. Health disparity i. A particular type of health difference that is closely linked with social economic, and/or environmental disadvantage b. Social determinants of health i. The conditions in which people are born, grow, live, work, and age 1. Economic Stability 2. Education Access and Quality 3. Health Care Access and Quality 4. Neighborhood and Built Environment 5. Social and Community context c. Marginalized groups i. Are more likely to have poor health outcomes and die earlier 1. Ex. LGBTQ, people of color, physically or mentally challenged, not college educated ii. Marginalization places or keeps someone in a powerless or an unimportant position within a society or group d. Intersectionality i. Research and policy model used to study complexities of people’s lives and experiences ii. Looks at how being marginalized affects people’s health and access to care iii. Describes the forces, factors, and power structures that shape and influence life  iv. Each of us is at the intersection of two categories 1. Privilege a. Having no difficulty accessing levels of care and other resources 2. Oppression a. Is a formal and informal system of advantages and disadvantages tied to membership in social groups, reinforced by societal norms, biases, interactions, and beliefs 7. Racial, Ethnic, and Cultural Identity a. Racial identity i. One’s self identification with one or more social groups in which a common heritage with a particular racial group is shared b. Ethnic Identity i. Along with racial identity, is a component of self-concept that places the focus on being part of a cultural group c. Cultural Identity d. Acculturation i. Individual or group transitions form one culture and develops traits of another culture e. Assimilation i. The individual adapts to the host’s cultural values and no longer prefers the components of the original culture f. Cultural respect i. As opposed to cultural competence ii. Critical to reducing health disparities and improving access to high- quality health care that is respectful and responsive to the needs of the diverse patient  8. Disease and Illness a. Illness i. The way which individuals and families react to disease ii. Culture affects how an individual defines the meaning of illness b. Disease i. Malfunctioning of biological or psychological processes c. Core measures i. Evidence-based standards of care ii. Key quality indicators that help health care institutions improve performance, increased accountability and reduce costs 9. A Model of Cultural Competence Campinah-Bacote Model of Cultural Competence Cultural Awareness Self-examination into- one’s own biases towards other cultures Cultural Knowledge Seeks and obtains educational base about culturally diverse groups Cultural Skills Ability to conduct a cultural assessment of a patient, to collect cultural data about patients’ problem Cultural Encounters Engaging in interactions with culturally diverse groups, in order to learn from them Cultural Desire The “Want to” engage in the process of becoming culturally aware 10. Cultural Awareness and knowledge a. Cultural awareness i. in-depth exploration of one’s own cultural and professional background b. Cultural knowledge  i. Learning or becoming educated about the beliefs and values of other cultures and diverse ethnic groups 1. Health-related beliefs and cultural values 2. Disease incidence and prevalence 3. Treatment efficacy c. Storytelling i. Helps identify the real problems affecting a patient’s health status and find culturally appropriate ways to intervene d. World view of providers and patient i. Iceberg analogy tool 1. Helps you visualize the visible and invisible aspects of your own worldview 2. Just as most icebergs lie beneath the surface of the water, most aspects of a person’s world view lie outside the person’s awareness and are invisible to those around the person ii. Conduct a comprehensive cultural assessment iii. Deeply held values reside “Underneath the iceberg” 11. Cultural Skill a. Collecting a patient’s history i. Ask open ended questions to find out information on patients’ culture b. Assessing health literacy i. Health literacy is the degree to which individuals have the capacity to obtain, process, and understand basic health information and the services needed to make appropriate health decisions c. Culturally based physical assessment d. Teach-back and plain language e. Working with interpreters  12. Cultural encounter and Desire a. Cultural encounter goals i. Communicate in a way that generates a wide variety of responses ii. Interact to validate, refine, or modify existing values, beliefs, and practices about a cultural group b. Cultural desire i. Having the motivation to engage patient so that you understand them from a cultural perspective 13. LEARN Model LEARN Model (For interacting with patient) Listen Listen to the patient’s perception of the problem. Nonjudgmental, and encourage Explain Explain your perception of the problem Acknowledge Acknowledge not only the differences between the two perceptions of the problem but also the similarities Recommend Recommendations must involve the patient Negotiate Negotiate a treatment plan. Consider that it is beneficial to incorporate selected aspects of the patient’s culture into the plan