NURSING THROUGH THE YEARS
2023 Pros/Cons of Healthcare
Cons:
MAJOR nursing shortage - nurses leaving profession
COVID-19 highlighted many issues
Lack of coordination in healthcare system
Cost
Pros:
Focus on prevention
Increased community health/resources
Increase telehealth/video-conferencing
Who was the pioneer of nursing? What did she focus on?
Who is Florence Nightingale
Instituted public health principles: sanitary conditions, infection control
Major influence on nursing research and statistics
Integrates best evidence from research with clinical expertise and patient-lens perspective.
Establish expectations for professional behavior to protect the nurse, client, and facility where care is practiced.
Hold nurses accountable for following a code of conduct and upholding ethical values.
What is STANDARDS OF PROFESSIONAL PRACTICE
What pointed out the most need for nurses and school for nurses?
What is WAR
1990s-2000s Challenges
Cost is a major concern
Lack of coordination - doctors didn't relay information to other doctors (patient would be the messenger)
Focused on treatment - rather than prevention
Nurses leaving the nursing field
Who was associated with the American Red Cross?
Who is Clara Barton
She noted a lack of medical supplies and advertised for donations
She traveled with many army ambulances
Qualitative vs Quantitative Research?
Which is more used/effective?
Quantitative: numbers, scientific metho of hypothesis testing
Qualitative: focuses on human phenomenon, quality of life and human experience
What is the 'Two-Step Process' within Scope of Practice?
1) The state legislature passes the nurse practice acts (NPA) to regulate nursing practice within their state
2) The state board of nursing (BON) enforces regulations and rules set by the NPA
The NPA provides the general guidelines, but each state creates rules and regulations to either further explain or make the NPA more detailed
What level(s) are the strongest use of evidence?
What level(s) are moderate?
What level(s) are weak?
1-3 STRONG
4-6 MODERATE
7- WEAKEST
1980's Concerns:
Rising health care costs
HIV/Aids emerges
Nursing shortage
Homelessness - people returned from the war
Who worked for better treatment of the mentally ill and prison conditions? What else was she known for?
Who is Dorthea Dix
Also known for convincing military officers that women could perform in the medical field and recruited more than 3,000 women to service her (Civil War)
Treatment routines based on specific disorders or circumstances are implemented for a specific client
Usually specific to a health care organization reflecting their standard of care and practice
What is Critical Pathways
What are the six-competencies the Quality and Safety Education for Nursing (QSEN) identified:
1)EBP
2)Safety
3)Patient-centered care
4)Informatics
5)Teamwork and collaboration
6)Quality improvement
The Affordable Care Act (2010)
-Make affordable health insurance available to more people
-Provides protection to those who are ACA funded services
-Expanding medicaid program with incomes below 138% of poverty level
-Lower health care costs
Changes in the 1970s
Women's movement of the 70's: increased opportunities in non-traditional female fields
Health care expanded further in the community
-Birthing centers, hospice programs, day care centers
Need for nurses increase with the Vietnam war
Who was the 1st African American registered nurse in the U.S? What else was she known for?
Who is Mary Mahoney
Primarily was a private duty nurse along the Eastern seaboard
She was a director of an orphanage
One of the original members of the ANA (originally called Nurses Associated Alumnae)
What is PICOT? Give an example
P: patient
-Fall risk patients
-Infants in the nicu
I: intervention
-High fall risk have different colored socks on
-Cup feeding throughout the hospital stay
C: comparison
-Normal socks
-Tube feeding throughout the hospital stay
O: outcome
-Less falls
-Greater reported success with breastfeeding post discharge
T: time (not always included) - hard to put a time limit on certain things
Human Flourishing, Nursing Judgement, Professional Identity, Spirit of Inquiry
What are The Four National League for Nursing (NLN) Competencies
What CAN'T LPN's do, that RNs can?
Cant do assessments, cant do IV pushes.
WWI and the 20's
Penicillin discovered by Fleming
Nursing shortage in US, because they were going overseas
Tell me something about:
Louisa Parsons
Lillian Wald
Lucille Petry
Esther McCready
Louisa: Founder of UMSON, influenced by model of Nightingale
Lillian: 1st public health nurses, approached insurance companies to provide free public health nurses to their policy holders
Lucille: CNO of U.S Health Public Service (1st woman in country to hold such rank)
Esther: Desegregated UMD, sued UMSON for admission
Validity vs Reliability
Validity: did the researchers do a good job conducting the study? Do the results represent true findings?
Reliability: Have their been similar outcomes by other researchers using the same interventions and research techniques?
What are the two national accreditation organizations?
The Accreditation Commission for Education in Nursing (ACEN)
Commission on Collegiate Nursing Education (CCNE)
What are the 5 categories regarding social determinants of health?
1) Access to health care
2) Economic stability
3) Education
4) Social and community context
5) Neighborhood and built environment