RNRS 100: Foundational Concepts of Nursing

• Describe the concepts of professionalism, legal and ethical issues and their impact on health care delivery.
• Describe the application of the nursing process and clinical judgment concepts as they relate to the delivery of care.
• Describe the concepts of safety, information technology, evidence-based practice and quality improvement as they relate to patient care.
• Identify teaching and learning principles as they relate to patient healthcare needs.
• Identify therapeutic communication and documentation techniques applied to patient care situations.
• Recognize the patient's cultural, ethnic, or spiritual needs and the impact on the patient's health and delivery of care.
• Describe concepts as it applies to caring interventions:\\na.) Safety: Assessment, accident, error, and injury prevention, emergency response plan, ergonomic principles, safe use of equipment, safe patient handling and transfers, hazardous and infectious material, standard precaution, transmission based precautions, restraints. \\nb.) Infection: Infection control, sepsis. \\nc.) Nutrition: Feeding (including the dysphagia patient), nasogastric insertion and feeding, intake measurements assessment.\\nd.) Elimination: Assessment, NGT suction, urine/stool specimen collection, intake and output measurements, toileting, urinary catheterization, bowel and bladder function (urinary and bowel incontinence, retention, constipation). \\ne.) Tissue integrity: Assessment, wound care, hygiene, bandages, wound drainage systems. \\nf.) Mobility: Range of motion, gait, ambulation (mobility and immobility), positioning, lifting, moving and transferring, muscle strength assessment. \\ng.) Glucose regulation: blood glucose monitoring. \\nh.) Perfusion: Vital signs, assessment. \\ni.) Oxygenation: Assessment, aspiration precautions, oxygen delivery, suctioning, oxygen saturation. \\nj.) Cognition: Assessment, level of consciousness (LOC), Glasgow Coma Scale (GCS).\\nk.) Comfort: Pain assessment, alternative and complementary therapy, rest and sleep. \\nl.) Sensory perception: Assessment, care of patients with hearing problems.

NCLEX Client Needs Categories:

Psychosocial Integrity, Management of Care

Concepts:

Communication, Professionalism, Safety, Evidence-Based Practice, Health Care Law, Ethics, Clinical Judgment, Informatics and Technology, Quality Improvement, Advocacy 

Communication Exemplars:

• Therapeutic communication
• Introduction to SBAR (Situation, Background, Assessment, Recommendation)
• Documentation
• Incivility
• Conflict resolution
• Continuity of care

Professionalism Exemplars:

• Team based learning
• Caring interventions
• History of nursing

Safety Exemplars:

• Quality and Safety Education for Nurses (QSEN)
• National Patient Safety Goals (NPSG)

Evidence-Based Practice Exemplars:

• Introduction to evidence-based practice

Health Care Law Exemplars:

• Health Insurance Portability and Accountability Act (HIPAA) - Confidentiality and information security
• Nurse Practice Act
• Advance directives
• Self determination
• Life planning
• Patient rights

Ethics Exemplars:

• American Nurses Association (ANA) Code of Ethics
• Ethical and legal issues

Clinical Judgment Exemplars:

• Holistic assessment
• Clinical judgment model
• Nursing process

Informatics and Technology Exemplars:

• Introduction to informatics and technology
• Patient records

Quality Improvement Exemplars:

• Introduction to quality improvement

Advocacy Exemplars:

• Resources
• Treatment options
• Information

Health and Illness Concepts

NCLEX Client Needs Categories:

Physiological Integrity, Basic Care and Comfort, Reduction risk potentials, Physiological Adaptation

Concepts Applied to Nursing Skills:

Safety, Infection, Nutrition, Elimination, Immunity, Tissue Integrity, Mobility, Glucose Regulation, Perfusion, Oxygenation, Cognition, Comfort, Sensory Perception

Safety Skills: 

Assessment, accident, error, and injury prevention, emergency response plan, ergonomic principles, safe use of equipment, safe patient handling and transfers, hazardous and infectious material, standard precaution, transmission based precautions, restraints. 

Infection:

Infection control, sepsis. 

Nutrition: 

Feeding (including the dysphagia patient), nasogastric insertion and feeding, intake measurements assessment.

Elimination:

Assessment, NGT suction, urine/stool specimen collection, intake and output measurements, toileting, urinary catheterization, bowel and bladder function (urinary and bowel incontinence, retention, constipation). 

Tissue integrity:

Assessment, wound care, hygiene, bandages, wound drainage systems.

Mobility:

Range of motion, gait, ambulation (mobility and immobility), positioning, lifting, moving and transferring, muscle strength assessment. 

Glucose regulation:

blood glucose monitoring. 

Perfusion:

Vital signs, assessment. 

Oxygenation:

Assessment, aspiration precautions, oxygen delivery, suctioning, oxygen saturation. 

Cognition:

Assessment, level of consciousness (LOC), Glasgow Coma Scale (GCS).

Comfort:

Pain assessment, alternative and complementary therapy, rest and sleep. 

Sensory perception:

Assessment, care of patients with hearing problems. 

Patient-Centered Care:

Provide holistic care that recognizes an individual's preferences, values, and needs and respects the patient or designee as a full partner in providing compassionate, coordinated, age and culturally appropriate, safe and effective care. 

Knowledge

1. Identifies multiple dimensions of patient-centered care including:

• Patient/family/community preferences and values 
• Coordination and integration of care
• Information, communication, and education
• Physical comfort and emotional support
• Involvement or family and/or significant other
• Care transition and continuity

Attitudes / Behaviors

1. Demonstrates valuing and respecting the patient's perspective and belief systems.
2. Demonstrates encouragement of patient's participation in decisions about health care and services. 

Skills

1. Assesses patient values, preferences, decisional capacity, and expressed needs as part of ongoing assessment, clinical interview, implementation of care plan, and evaluation of care. 
2. Communicates patient values, preferences, and expressed needs to other members of the health care team. 

Professionalism:

Demonstrate accountability for the delivery of standard-based nursing care that is consistent with moral, altruistic, legal, ethical, regulatory, and humanistic principles.

Knowledge

1. Identifies the professional standards of practice, the evaluation of that practice, and the responsibility and accountability for the outcome of practice. 

Attitudes / Behaviors

1. Accepts responsibility for own behavior. 
2. Demonstrates respect for others during clinical activities (i.e. no talking while others are talking, cell phones are silenced, and no inappropriate use of computers).

Skills

1. Implements plan of care within legal, ethical, and regulatory framework of nursing practice. 
2. Demonstrates ability for reflection in action, reflection for action, and reflection on action. 
3. Serves as a patient advocate. 
4. Utilizes and ethical decision-making framework in clinical situations. 
5. Complies with the Standards of Practice, policies and procedures of the nursing program and clinical agency. 
6. Completes assignments as required and scheduled. 
7. Provides prior notification to appropriate faculty when they are unable to meet commitments or requirements. 
8. Participates in clinical activities as scheduled, arriving on time and prepared for the daily assignment throughout the length of the nursing program. 
9. Demonstrates professional appearance and professional presentation in clinical settings. 
10. Demonstrates respect and politeness to all individuals regardless of culture, ethnicity, religion, work experience, gender, age, and sexual orientation. 
11. Maintains confidentiality of all patient information in conversation, electronic and written means. 
12. Provides and receives constructive feedback to/from instructor and peers. 

Leadership:

Influence the behavior of individuals or groups of individuals within their environment in a way that will facilitate the establishment and acquisition/achievement of shared goals.

Knowledge

1. Identifies leadership skills essential to the practice of nursing.

Attitudes / Behaviors

1. Verbalizes the role of the nurse as a leader. 
2. Accepts accountability for nursing care delegated to others. 
3. Verbalizes the value of leadership to empower others and enhance collaboration and shared decision making. 

Skills

1. Integrates leadership skills of systems thinking, communication, and facilitating change in meeting patient care needs. 

System-Based Practice:

Demonstrate an awareness of and responsiveness to the larger context of the healthcare system, and will demonstrate the ability to effectively call on work unity resources to provided care that is of optimal quality and value.  

Knowledge

1. Discusses the role and responsibilities as a member of the health care team in planning and using work unit resources to achieve quality patient outcomes. 

Attitudes / Behaviors

1. Articulates the complexity of individual and team practice on a work unit. 
2. Appreciates role in identifying work unit inefficiencies and operational failures. 

Skills

1. Plans, organizes, and delivers patient care in the context of the work unit. 
2. Participates in solving work unit inefficiencies and operational failures that impact patient care, such as those involving supplies, medications, equipment, and information. 
3. Selects resources available on the work unit when contributing to the plan of care for a patient or group of patients. 
4. Collaborates with members of the healthcare team to prioritize resources, including one's own work time and activities delegated to others, for the purposes of achieving quality patient outcomes. 
5. Evaluates outcomes of one's own nursing care. 
6. Uses education and referral to assist the patient and family through care transitions. 

Informatics and Technology:

Use advanced technology to analyze as well as synthesize information and collaborate in order to make critical decisions that optimize patient outcomes. 

Knowledge

1. Describe the use of electronic communication strategies among healthcare providers in the healthcare system. 

Attitudes / Behaviors

1. Values and protects confidentiality of protected health information. 

Skills

1. Uses the electronic health record system to access relevant patient information, including accessing and interpreting patient history, diagnostic and laboratory findings. 
2. Utilizes technology fully and accurately document patient assessment, plan of care, referrals, and care provided. 

Communication:

Interact effectively with patients, families, and colleagues, fostering mutual respect and shared decision making, to enhance patient satisfaction and health outcomes. 

Knowledge

1. Outlines the principles of effective communication through various means. 

2. Selects appropriate grammar, spelling, and health care terminology. 

Attitudes / Behaviors

1. Values individual cultural and personal diversity. 

Skills

1. Uses clear, concise, and effective written, electronic, and verbal communications. 
2. Documents interventions and outcomes of care according to professional standards and work unit policy. 
3. Demonstrates effective interviewing techniques and adapts communication as needed based on patient's response. 
4. Uses standardized communication approaches (e.g. SBAR) in all communications and in care transitions. 

Teaching and Learning:

Knowledge

1. Describes the principles of teaching and learning. 

Attitudes / Behavior

1. Values different means of communication used by patients and families. 

Skills

1. Assesses factors that influence the patient's and family's ability to learn, including readiness to learn, preferences for learning style, and levels of health literacy. 

Teamwork and Collaboration:

Function effectively within nursing and interdisciplinary teams, fostering open communication, mutual respect, shared decision-making, team learning, and development. 

Knowledge

1. Identifies own strengths, limitations, and values in functioning as a member of a team. 
2. Discusses the impact of the effective collegial communication on patient outcomes. 
3. Discusses how authority and hierarchy influence teamwork and patient safety. 

Attitudes / Behavior

1. Appreciates the importance of collaboration

Skills

1. Acts with honesty and integrity when working with patients, families, and team members. 
2. Functions competently within own scope of practice as a member of the health care team. 
3. Follows communication practices to minimize risks associated with transfers between providers during care transitions. 
4. Interacts effectively with team members. 

Safety:

Minimize risk of harm to patients and providers through both system effectiveness and individual performance. 

Knowledge

1. Identifies human factors and basic safety design principles that affect safety. 
2. Describes the benefits and limitations of commonly used safety technology. 

Attitudes / Behaviors

1. Verbalizes that both individuals and systems are accountable for a safe culture. 

Skills

1. Demonstrates effective use of technology and standardized practices that support safe practice. 
2. Communicates observations or concerns related to hazards and errors involving patients, families, and/or healthcare team. 
3. Sufficiently prepares for and completes clinical assignments to implement safe and effective care, including identifying key nursing assessment data, analyzing data, developing priority nursing diagnoses, plans of care, interventions, and evaluation criteria. 
4. Demonstrates clinical judgment in the performance of care, skills, and education. 

Quality Improvement:

Use data to monitor the outcomes of care processes, and use improvement methods to design and test changes to continuously improve the quality and safety of health care systems. 

Knowledge

1. Explains how nursing contributes to systems of care and processes that affect outcomes. 

Attitudes / Behaviors

1. Verbalizes that quality improvement is an essential part of nursing. 

Skills

1. Actively seeks information about quality initiatives in their own care settings and organization. 

Evidence-Based Practice:

Identify, evaluate, and use the best current evidence coupled with clinical expertise and consideration of patients' preferences, experience and values to make practice decisions. 

Knowledge

1. Identifies evidence-based rationale when developing and/or modifying clinical practices. 

Attitudes / Behaviors

1. Values the concept of evidence-based practice (EBP) as integral to determining best clinical practice. 

Skills

1. Utilizes best current evidence, patient values, and clinical expertise in clinical practice.