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Florence Nightingale mid 1800s
English woman studied in Germany with a Protestant order
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Nightingale focused on
cleaning up wards and improving ventilation, sanitation, and nutrition, her group of 38 nurses lowered the death rate from 60% to 1%.
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Based curriculum on following beliefs:
- 1. Nutrition is an important part of nursing
- 2. Fresh, clean air is beneficial to the sick
- 3. Sick people need occupational and recreational therapy
- 4. Nurses meet pts personal needs, provide emotional support
- 5. health and illness
- 6. Continuing ed is needed for nurses
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Dorothea Dix- social worker
appointed by the Union govt to organize women volunteers to provide aid to soldiers
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Clara Barton
founded the American Red Cross
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Lillian Ward in 1893
established the Henry Street Settlement in New York City. training period from 6 months to 3 years.
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Apprenticeship is
learning by doing
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In an era when women were expected to remain at home and be subservient to men,
nurses' training became a way to obtain further education and employment that could provide independence for women.
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1892 New York Young Women's Christian Association
started the Ballard School, which offered a 3 month course in practical nursing.
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Richard Bradley in 1907
opened a practical nursing school in Brattleboro, Vermont.
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In 1918 group of women opened the
Household Nursing School in Boston- later called Shepard Gill School of Practical Nursing.
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During WWI
nurses worked behind the lines to care for sick and wounded soldiers.
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During WWII
created a demand for nurses in military hospitals, and training programs had to be increased.
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Four common goals:
- 1. promote wellness
- 2. prevent illness
- 3. facilitate coping
- 4. restore health
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To accomplish goals, practical nurse takes on the role of
caregiver, educator, collaborator, and manager.
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Interventions are
actions taken to improve, maintain, or restore health or prevent illness.
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Invasive procedures are
procedures that require entry into the body.
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Nurses provide both
physical and emotional care to patients.
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The Nurse's goal is to
encourage growth toward wellness so that the patient can once again be self reliant.
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Aseptically
without introducing infectious material
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Active listening is
a therapeutic technique that helps the patient consider possible solutions when a problem occurs.
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A Nursing theory is a
statement about relationships among concepts or facts, based on existing information.
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Nursing theorists generally base
their beliefs on the relationships among humans, evnironment, health and nursing.
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Evidence based nursing involves
the integration of best research evidence with clnical expertise and patient values to facilitate clinical decision making.
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Evidence based practice is using
the best scientific evidence from research to guide decision making and used to help determine best practices.
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Virginia Henderson 1955
To help clients gain independence in meeting their needs as quick as possible
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Dorothy Johnson 1968
To reduce stress, allowing the client to recover as quickly as possible
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Martha Rogers 1970
To achieve maximum levels of wellness
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Dorothea Orem 1971
To care for and help clients with various needs attain self care
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Betty Neumann 1972
To assist individuals, families, and groups to attain and maintain maximum levels of total wellness through purposeful interventions
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Sister Callista Roy 1976
To identify types of demands placed on client and client's adaptation to them
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Jean Watson 1979
To promote health, restore clients to health, and prevent illness.
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Rosemarie Parse 1987
- 1. To assist client in interaction with the environment and in co-creating health
- 2. To care about the client as an individual
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Patricia Benner and Judith Wrubel 1989
To care about the client as an individual
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Authorized (Acts of Nursing)
those nursing activities made legal through state nurse practice acts
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Lateral Expansion of Knowledge is
an extension of the basic core of information learned in the school of practical nursing
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Peer Review is
a formal evaluation of performance on the job by other LP/VNs
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Specialized Nursing Practice is
a restricted field of nursing in which a person is particularly skilled and has specific knowledge.
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Therapeutic Regimens are
regulated plans designed to bring about effective treatment of disease.
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Milieu
one's environment and surroundings.
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Protocols are
courses of treatment which include specific steps to be performed in a stated order.
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The Practice Acts
generally define activities in which nurses may engage, state the legal requirements and titles for nursing licensure, and establish the education needed for licensure.
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Practice Acts are
designed to protect the public, and they define the legal scope of practice.
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Nursing Process 1970s and 1980s
organized, deliberate, systemic way to deliver nursing care.
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National Association for Practical Nurse Education and Service (NAPNES) was
formed to standardize practical nurse education and to establish licensure criteria for graduates.
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Diagnosis-related groups (DRG's)
were created by Medicare in 1983 as an attempt to contain health care costs. Hospital receives a set amount of money for a patient who is hospitalized with a certain diagnosis.
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Integrated delivery network is
a set of providers and services organized to deliver coordinated care to promote wellness, care for illness, and promote rehabilitation.
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Capitated Cost
network performs these services that are paid a set fee for every patient enrolled in the network each year.
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6 levels of care within health care system:
- 1. preventive
- 2. primary
- 3. secondary
- 4. tertiary
- 5. restorative
- 6. continuing care
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Health Maintenance Organization (HMOs)
type of group practice, enroll patients for a set per month. One goal to keep pts healthy and out of the hospital.
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Preferred Provider Organization (PPOs)
offer a discount on fees in return for a large pool of potential patients.
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Vigilant assessment which documentation is
more important than ever in order to catch beginning complications before they become serious.
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