The 4 Spheres of Healthcare
- Disease prevention/health promotion
- Chronic disease care
- regenerative or restorative care
- Hospice/palliative/support care
Where is med/surg practiced at
- acute care hospitals
- snf
- ambulatory care settings
- patient home( at times)
What roles do med/surg nurses do ?
- care coordinator
- transition manager
- caregiver
- patient educator
- leader
- patient
- family advocate
What are the 6 core QSEN competencies ?
- patient centered care
- collaboration
- evidence based practice
- quality improvement ( PDSA, PDCA)
- informatics ( electronic record)
- safety
What are common healthcare errors?
- Miscommunication
- Inattentiveness
- misjudgment
- poor prevention
- medication errors
- misinterpretation of Rx
- unprofessionalism
- skill gaps
- hiding ( ex.. too long of breaks)
For teamwork and collaboration skills, what is needed?
- mutual respect
- responsibilities
- relationships
- healthy communication (SBAR, closed loop, Interprofessional communication competencies)
I SBAR
I = identify yourself
I SBAR R
I = identify yourself
R= response from receiver
SBAR Q
Q= questions from receiver
TEAM S.T.E.P.P.S
s- strategies
t- tools
e - enhance
p - performance
p - patient
s - safety
CUS words are ?
I’m Concernced
I’m Uncomfortable
I don’t feel Safe
Check backs are?
restating what the person said to verify understanding-> close the loop
What is a call out?
shouting out important info for all team members to hear 1x (ex.. vital signs)
What is the 2 challenge rule?
stating a concern 2x as needed, then if ignored follow the chain of command to get it addressed
What are the 5 rights of delegation and supervision process?
- task
- circumstance
- person
- communication
- supervision
What is the nurse’s role in Quality Improvement process?
- Identify a problem ( plan)
- gather data ( do)
- recommend (study)
- implement ( act)
What are 3 ways that informatics and technology are used in healthcare?
- EMR
- internet
- RFID ( radiofrequency identification)
- BCMA ( barcode medication administration
- smart IV pumps
What type of education does a med/surg do?
- preop, post op
- health teaching
- medication/treatment education
What are some clinical judgments that med/surg nurses do?
- noticing
- interpreting
- responding
- reflecting
Poor judgment can lead to?
failure to rescue
What are some key attributes of failure to rescue?
- errors of omission
- failure to see changes in pt condition
- failure to communicate pt changes
- failure to make clinical decisions
- clinical bias or anchoring
What are the 6 major ethic principles that help decision making and clinical judgment?
- autonomy
- beneficence( positive actions)
- nonmaleficence ( prevent harm)
- fidelity ( promises to pt, obligations)
- veracity ( tell the truth)
- social justice( equality)
What are the social determinates of health?
- economic stability
- education access
- health care access
- environment/neighborhood
- community/social context
Who are at risk for health care disparities?
- older adults
- ethnic minorities
- LGBTG community
