Nursing History: Early Nursing Care

sick, elderly, weak, helpless individuals

compassion, kindness, health promotion

- 1873 George ebers
- 700+ remedies
- acute description of circulatory system and cardiac functions

- Hebrews developed hygiene codes
1. disinfection, sanitation, food prep
- jews quarantines infectious diseases
1. disposed of trash outside of cities

- hippocrates was the father of medicine and published remedies
- remedies were kept hidden by the priests

blood, bile, phlegm, and black bile

fire, water, air, earth

sanguine, choleric, phlegmatic, or melancholic

diseases arose leading to faulty and ineffective treatments

- the romans had nursing emerge as a role
- mobile war nursing units arose ( wards, pharmacies, private rooms for healing)
- development of sewer systems
- galen

- greatest greek physician
- greatest researcher before the 1600's
- transformed healing practices

- roman military hospitals were replaced with civilian ones
- nurses were known as deaconesses
- med schools and hospitals increases
- surge of diseases

- closures of hospitals (nuns and nurses dissolved)
- creation of public hospitals
- poor nursing conditions
- nurses were seen of low status and inferior

filthy, where people went ti die, unqualified people cared for the sick, hard to find working women

first true hospital
founded in 1751

- economic system increased
- over crowding
- poor sanitation
- Chadwick report
- shattuck report

-Edwin Chadwick
- development of public health
- 1848 first board of health
- social reform for child welfare, elderly care, mentally ill, etc

- lamuel shattuck
- infant mortality rate was at a high
- development of state board of health in 1869 (FDA thingy)

Established sanitary nursing care units. Founder of modern nursing. began professional education of nursing.

- English general hospital
- lack of care and supplies
- mortality rate from war was 42-73%

- she demanded clean dressings, bedding, and fresh air
- emphasized proper sanitation and appealing food to help patients get better
- this reduced the mortality rate by 27%

- the beginning of the nursing profession
- was a 1 year nursing program
- hand picked students attended
- the book "notes of nursing" acted as a textbook

- health maintenance and promote wellness
-the first theme focused on poverty and its effects on health
- second theme: promoting self care and teaching families how to manage a healthy environment

1903

created planned parenthood

first African American female to graduate from nursing school

- created public health nursing"
- established Henry street settlement (where public needs were addressed)
- founded school nursing
- employed 25 African American nurses and gave them equal pay

founded Red Cross

accessed patients via horseback in rural hyden ky and provided primary care, prenatal, post natal care with an emphasis on prevention
- lowered the highest maternal mortality rate in the us to below national average

- 1965
- formalized nursing education in colleges and university's

- sponsored quality and safety education of nurses
- goal was to prepare future nurses to improve patient healthcare system

- aimed at preventive care
- went into law in 2012
- provided affordable and accessible healthcare to Americans

- person
- health
- environment
-nursing

- the critical analysis of funds,ntal assumptions or beliefs
- the discipline composed of logic, ethics, aestheics, metaphysics, and epistemology

- the supernatural
- something could not come from nothing

Knowledge comes from our own experiences.

- a lens in which we see the world
- views lie between realism and idealism

indicate what we value

true or false

good or bad

what people should(pre) or should not (pro) do

principles and ideals that give meaning and direction to our social personal and professional lives

what you value

Care that is respectful of and responsive to individual patient preferences, needs, and values and ensures that patient values guide all clinical decisions

broad range of individuals, age, gender, race, socioeconomic status, religious beliefs

-the ability to recognize the differences in the resources or knowledge needed to allow individuals to fully participate in society
- fairness, prejudice, sterotypes

working to ensure the perspectives and experiences of others are invited, welcomed, and respected,

the condition in which people are born, grow, learn, live, work, etc

is the knowledge, skills, attitudes, and behavior required to provide optimal care to those of various cultural backgrounds
- with a lack of this our society cannot improve the nations health

racial or ethic differences in the quality of healthcare

differences in care based on out lying factors

predisposed point of view

someone who is aware of their evaluation of a group and believes it as true

The unintentional, subconscious associations every individual makes among groups of people and stereotypes about those groups.

a nurse will provide holistic care that recognizes patient preferences by expressing Safe appropriate and effective care

- respect for persons values, prefs, needs
- coordination and integration of care
- information, communication, and education
- physical comfort
- emotional suport
- involvement of family and friends
- access to care

-coordination of care conference (rounds)
- hourly rounding by the nurse
- bedside report
- use patient care partner (tech)
- individualized care(everyone is different)
- open medical report policy
- eliminating visiting restrictions
- allowing family presence during invasive procedures
- silence and healing environment

a nurse interacting effectively with patients, fostering mutual decision making to enhance satisfaction and health outcomes

behaviorS and non empathetic communication

-listening to patient
- using appropriate vocabulary
- using preferred name
- being respectful
- ask what they need
- soliciting feedback
- provide words of comfort

- interrupting with irrelevant stuff
- using wrong vocab
- using patronizing lang
- using non professional lang
- scolding
- preaching to them
- being inappropriate
- self disclosing

specific questions that can help clinicians relate to a patient on his or her level to provide PCC

any set of planner educational activities designed to improve patients health behaviors and status

activities aimed at improving knowledge

cognitive, psychomotor, affective

intellectual skills, application, analysis

learning skills and performance of them such as walking and sitting up

requires a change in feelings, attitudes, or beliefs

the art and science of teaching adults

- why something is important
- showing how to direct themselves through information
- relating the topic to their experiences
- realizing people won't learn until they are ready and motivated

the likelihood of acting in response to health threat is dependent upon 6 factors

- persons perception of severity snd suscepibility of the illness
- value of the treatment benefits
- barriers to treatment
- physical and emotional treatment cost
- taking action toward treatment

if one believes they can preform a behavior and that it will lead to a desired outcome they are more likely to do it

- performance accomplishments
-vicarious experience or molding
- verbal persuasion
- interpretation of physiological state

- assesment
- planning
- implementation
- evaluation

- what is my main problem
- what do I need to do
- why is it important for me to do this

asses, compare, teach, survery

- material contain information that the patient wants and needs
- the patient understands and uses the material as presented

- cognitive changes
- visual changes
- changes in hearing

- storing information
- retrieval of information
- decrease in processing speed

- smaller amount of light reacher retina
- ability to focus
- scattering of light (glare)
- color perception
- depth perception changes

- reduced ability to hear sounds as loud
- decrease in hearing acuity
- decrease in hearing high pitched sounds
- decrease in ability to filter noise

- slow presentation
- smaller amounts of information
- repeat info
- reduce distractions

- make sure glasses are available and clean
- printed material with 14-16 font
- bold print
- avoid dark colors and dark backgrounds
- light should shine from behind learner
- position materials directly in front of learner

- speak distinctly
- don't shout
- speak in lower pitch
- face the person
- decrease excess noise

- adapt information to be more specific
- incorporate aa groups beliefs

survey that patients take

Quality and Safety Education in Nursing

- PCC
- evidence based practice
- team and collaboration
- safety
- quality improvement
- informatics

Decreased risk of harm by individual actions or system design. and the development of safer systems

failure of planned action or completing wrong plan

care not provided or mussed care to a patient

-TERCAP(taxonomy of error, root cause analysis, and practice responsibility)

communication
patient management
clunical preformance

organization failure
failure of system processes
technical failure

Skill based, knowledge based, rule based

-emphasis on safety
- new health system for 21st century
- performance expectations

- user centered designs
- reducing reliance on memory
- work conditions (work load, hours, staffing ratios)
- utilizations of check lists, visual and auditory alarms, and avoiding long shifts
- teamwork
- include the family in care regimen
- anticipation of potential errors
- plan for recovery when errors occur

priority expectations
(safe, timely, effective, efficient, equitable, patient centered)

- largest category of errors
- provider is expected to increasers education related to meds

-ID patients
-Triple check meds (check at pixus, check during preparation, scan armband)
- improve med labels and packaging

- improve quality
- measure and report public performances
- 7 categories to decrease errors

- sustaining safety
- life sustaining treatment
- disclosure
- care of care giver
- matching healthcare needs to serve of facility
- clear communication
- med management
- prevention of healthcare associated infections
- site specific practices to include of falls, pressure ulcers, and wrong surgery sites

- safe med administration
- communication
- prevent mistakes in surgery
- utilizing alarms

Errors in medical care that are clearly identifiable, preventable, and serious in their consequences for patients.
- ex: suicide, sexual assault, death by fall

Unexpected occurrences involving death or serious physical or psychological injury, or the risk thereof. Serious injury includes loss of limb or function. Sentinel events indicate the need for immediate investigation and response.
- ex: death in restraints, suicide, meds error, wrong surgery
what is

the degree of consistent healthcare services that increases the likelihood for desired outcomes and is the utilization of data to monitor outcomes

care bundle is specific sets of research for certain types of people

- benchmarking (best practices)
- core measures (standard performance)
- accountability
- composite measures (computing percentage)

a rigorous statistical analysis process that reduces defects in manufacturing and service-related processes