expert contact me only
Infection Prevention and Control (IPAC)
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Norwalk Virus
Overview: Norwalk virus causes acute gastrointestinal illness sporadically or in outbreaks.
Mode of transmission: direct and indirect contact. Can be aerosolized from emesis.
Incubation period and period of infectivity: Symptoms usually develop 12 to 48 hours after being exposed, and recovery typically occurs within 1 to 3 days. Can be transmitted from infection to 3 days after illness.
Treatment: no specific treatment, supportive management only.
Preventative measures and vaccinations: prevention involves proper hand washing and disinfection of contaminated surfaces. Alcohol-based sanitizers are not effective against the Norwalk virus. Vaccine under development.
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Vancomycin-Resistant Enterococcus (VRE)
Overview: type of bacteria present in the gastrointestinal tract and the female genital tract that develop resistance to many antibiotics, especially vancomycin.
Mode of transmission – direct and indirect contact.
Incubation period and period of infectivity: The incubation period is variable and indefinite. Occurs commonly around 4 – 10 days after exposure. Enterococcus can live on hands for as long as 60 minutes after contact and as long as four months on inanimate surfaces. Can be transmitted until the person is cured.
Treatment: Most VRE infections can be treated with antibiotics other than vancomycin. Doxycycline, chloramphenicol, and rifampin in various combinations have been used to treat VRE infections, but the newer antibiotic choices are also now available. No vaccine.
Preventative measures and vaccinations: prevention involves proper hand washing and disinfection of contaminated surfaces. No current vaccine.
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Extended Spectrum Beta-Lactamase (ESBL)
Overview: ESBL is an enzyme found in some strains of bacteria that make them resistant to antibiotics. These bacteria include Escherichia coli (E. coli) and Klebsiella pneumoniae. ESBL infections are serious and can be life-threatening.
Mode of transmission – direct and indirect contact.
Incubation period and period of infectivity: The incubation period is variable. It occurs commonly around 4–10 days. A person can spread ESBL as long as they are colonized.
Treatment: antibiotics the bacteria is not resistant to such as Carbapenems. Supportive treatment for the infection.
Preventative measures and vaccinations: prevention involves proper hand washing and disinfection of contaminated surfaces. No current vaccine.
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Measles
Overview: Measles i
Communication in Clinical Practice
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Patient and Family Centred Care
It is important to acknowledge that patient- and family-centred care focuses on the whole person as a unique individual and not just on their illness or disease.
In viewing the individual through this lens, health-care providers come to know and understand the person’s life story, experience of health, the role of family in the person’s life, and the role they may play in supporting the person to achieve health.
Potter & Perry, 2019
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Data Collection
First step in nursing process is assessment
Nurses collect pertinent data about the client’s health or situation.
This includes information from the nursing health history and physical assessment
Potter & Perry, 2019
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Sources of Data
Primary
Secondary
Tertiary
Potter & Perry, 2019
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Nursing Interview – Purpose
Obtain a nursing health history, identify health problems and risk factors
Reason for seeking care
Patient’s perception of the illness
Provides subjective data
Why is this important?
Potter & Perry, 2019
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Phases of an Interview
Orientation – introduction and purpose of interview
Working – gather information, observe verbal and non-verbal behaviour
Termination – end interview
Potter & Perry, 2019
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Questioning Techniques – Open-ended Questions
Explore broader issues
Invite longer answers
Encourage patients to discuss and elaborate
Identify patient’s priorities
Potter & Perry, 2019
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Questioning Techniques – Closed-ended Questions
Can be answered with a yes or no
Do not invite discussion
No additional information is required
Potter & Perry, 2019
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Nursing and Cultural Diversity
What are the challenges in cross cultural communication?
What strategies can we use to overcome them?
Potter & Perry, 2019
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Nurse-Client Interviews with Patients with Special Needs
Our duty to elicit the information
Must adapt communication so that the patient can understand it and we can understand the answe
Welcome to PNC 121
Practical Nursing – Clinical Preparation
Overview of PNC 121 and Addendum
Blackboard
Course Description
Academic Integrity
Discrimination/Harassment
Academic Accommodations
Late Assignments/Assignment Extension
Request for Deferred Evaluation Privilege
Modes of Evaluation
| Evaluation | Explanation | Percentage of Final Grade |
| Class Assignments | 4 assignments on content worth 5% or 10% each | 25% |
| 2-Part Nursing Care Plan Assignment | Part 1 = 5% Part 2 = 10% |
15% |
| Infection Prevention and Control (IPAC) Group PowerPoint and Presentation | In class group presentation = 6% Group power point = 4% |
10% |
| Midterm Exam | Multiple Choice and/or Alternate Format Questions on weeks 1-6 | 24% |
| Final Exam | Comprehensive multiple Choice and/or Alternate Format Questions | 26% |
The Online Community
In order to get to know each other please post an introduction to yourself in the Discussion Forum by next class. This should include a short description of yourself and why you want to be a nurse.
Definitions of Nurses
What is your definition of a Nurse?
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Common Themes in Nursing
Patient focus – patient centred care
Information focus – how information is used
Quality improvement – many aspects to improve care
Staff focus – healthier working environments improve patient outcome
Leadership – critical in shaping care
Potter & Perry, 2019
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Issues and Trends in Practical Nursing
Educational preparation and entry to practice competencies
Registration
Continuing education
The role of the practical nurse
Workplace issues
Workforce trends
Potter & Perry, 2019
Who are the Recipients of Care
Individuals
Groups
Organizations
Communities
Potter & Perry, 2019
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What are the different Practice Settings?
Institutional Sector
Community Sector
Potter & Perry, 2019
Categories of Nurses
RN
RPN
Nurse Practitioner
Client Safety & Safe Working Environments Potter & Perry, 2019) 1 Client Safety The aim of the Canadian health care system is to provide quality care and access for all. This includes the following: Cultural Competence, Safety and Humility Evidence-Informed Practice (EIP) Quality and Patient Safety Quality Workplaces Improved Patient Outcome Metrics Potter & Perry, 2019) 2 Quality Care How is quality care delivered? How do nurses achieve quality in nursing practice? Potter & Perry, 2019) 3 Quality Improvement and Risk Management Risk management is a system of ensuring appropriate care by identifying potential hazards and preventing harm from occurring. One tool used in risk management is the “incident report” or “adverse occurrence report” By tracking incidents areas for improvement can be identified Potter & Perry, 2019) 4 Patient Safety Incidents (or Adverse Events) An event or circumstance that could have resulted, or did result in unnecessary harm to a patient Harmful incident – resulted in patient harm Near miss- did not reach the patient No-harm incident – reached the patient but did no harm Potter & Perry, 2019) 5 Factors Affecting Patient Safety Patient and Provider Factors Task Factors Technology Factors Environmental Factors Organizational Factors Potter & Perry, 2019) 6 Risk Factors at Developmental Stages Infant/toddlers – poisoning Toddlers/preschoolers – not restrained properly in vehicles, drowning Adolescents – risk taking behavior, substance use Adults – accidents due to alcohol or drugs Older people – age related changes Potter & Perry, 2019) Risk Factors in the Home Environment Physiological Environmental Potter & Perry, 2019) 8 Fire Safety in the Home Environment Smoke detectors on every floor of the house Have a fire extinguisher at home What other fire risks are there in the home environment? Potter & Perry, 2019) 9 Risk Factors in the Health Care Environment What can the nurse do to improve safety for patients in hospital? Potter & Perry, 2019)
Documentation What is Documentation? * * Purpose of Nursing Documentation (CNO, 2008) * * What Activities do Nurses Document? * * What is a Medical Record? (Client Record or Chart) Potter & Perry, 2019 * Potter & Perry, 2019 Purpose of Medical Records (Client’s Records or Charts) Potter & Perry, 2019 * Potter & Perry, 2019 * Access to Client’s Charts and Documentation Where are client’s charts kept in community settings, hospitals, doctor’s offices, and long term care facilities? Who has access to them? Potter & Perry, 2019 * Potter & Perry, 2019 * Ethical and Legal Considerations of Documentation Potter & Perry, 2019 * Pott Preparing for Client Care
Nursing Research Critical Thing & Reasoning 1 Development of Research in Nursing Started with Florence Nightingale First nursing research journal published in Canada was in 1969 called Nursing Papers Copyright © 2019 Elsevier Canada, a division of Reed Elsevier Canada, Ltd. 2 2 Research Some research tests nursing theories; other research generates theory from findings Nurse’s examine factors relevant to nursing in the context of the larger health care picture The scientific knowledge needed for nursing is discovered, tested and enhanced through research Copyright © 2019 Elsevier Canada, a division of Reed Elsevier Canada, Ltd. 3 Clinical Research Expectations Clinical research is dynamic Needs to be reviewed and updated regularly so that the information is current/relevant Copyright © 2019 Elsevier Canada, a division of Reed Elsevier Canada, Ltd. 4 Research Literacy An essential competency for evidence-informed practice; It is the ability to locate, understand and critically evaluate empirical literature for application in practice When critiquing evidence first evaluate the scientific merit and clinical applicability of each studies findings Do the articles together offer evidence to explain or answer your question? Do the articles show that the evidence is true and reliable? Can you use the evidence in practice? Copyright © 2019 Elsevier Canada, a division of Reed Elsevier Canada, Ltd. 5 Evidence-Based Nursing The evidence-based nurse knows what needs to be done, how it should be done, and the evidence that supports his or her practice. “Armed with evidence!” Copyright © 2019 Elsevier Canada, a division of Reed Elsevier Canada, Ltd. 6 Evidence-Informed Practice (EIP) Basing health care decisions upon evidence is essential for quality care in all domains of nursing practice Evidence-informed clinical decision making is affected by: Evidence from research and theories Evidence from patient assessment and health care resources Clinical expertise Patient preferences and actions Copyright © 2019 Elsevier Canada, a division of Reed Elsevier Canada, Ltd. 7 7 Steps of the Evidence-Informed Practice Process Copyright © 2019 Elsevier Canada, a division of Reed Elsevier Canada, Ltd. 8 8 RNAO Best Practice G The Nursing Process & Care Plan Development Potter & Perry (2019) 1 What is the nursing process?
Intellectual process of reasoning Aims to identify, diagnose, and treat actual and potential health issues and challenges of clients from a holistic perspective Guides clinical judgement, decision making, and reflective practice Encourages critical thinking Potter & Perry (2019) 2 5 Phases of the Nursing Process Potter & Perry (2019) 3 Phase one : Assessment Systematic collection of data to determine the client’s current and past health and functional status. Nurse collects a variety of different types of data in order to fully understand the client priority needs(can you think of types of data that may be collected by the nurse?) Holistic and comprehensive assessment Potter & Perry (2019) 4 Phase Two: Diagnosis Nurse analyzes the assessment data in order to determine the key issues and make clinical judgements in the form of a nursing diagnosis This step directs the plan of care for the client Identify outcomes for the client that are individualized to the client and the client’s situation Potter & Perry (2019) 5 Phase Three: Planning Creation of a formal plan Prescribes strategies and alternatives to attain the expected outcome Potter & Perry (2019) 6 Phase Four: Implementation Carrying out the plan May occur by coordinating care delivery, providing health teaching and health promotion activities, , consulting with other health care professionals, or providing medications or other therapies (can you think of any other examples?) Potter & Perry (2019) 7 Phase Five: Evaluation Evaluating the client’s response to the selected interventions Determine whether the interventions were effective Potter & Perry (2019) 8 Let’s look at each phase in more detail Potter & Perry (2019) 9 Phase One – Assessment Critical thinking is foundational to a comprehensive and accurate nursing assessment Enables the nurse to have a broader perspective from which to form conclusions and make decision concerning client’s health condition Includes collection and verification of data f Communication Overview What is communication? A means of persuasion to influence other so that the desired effect is achieved A process by which two or more people exchange ideas, facts, feelings, or impression in ways that each gains a common understanding of the meaning, intent and use of a message A lifelong process for the nurse. Nurses must communicate effectively with patient, colleagues, family members and interprofessional teams(where some times team members have different priorities) Potter & Perry, 2019 2 2 Therapeutic Communication Used by health care workers Focuses on advancing the physical and emotional well-being of a patient Uses specific techniques to encourage the expression of feelings and ideas and coveys acceptance and respect Potter & Perry, 2019 3 Interprofessional and Intraprofessional Communication Interprofessional – communication between members of different health care teams Intraprofessional – communication occurring between members of the same health care team Potter & Perry, 2019 4 Intrapersonal Communication Known as ‘Self-talk” or “inner thought” Occurs within an individual Helps develop self-awareness and positive self-concept Can facilitate self-expression May improve health and self-esteem Potter & Perry, 2019 5 Interpersonal Communication Face to face interaction between the nurse and the client The most common type of communication used in the health care setting Nurses take into consideration client’s values, belief systems, opinions and experiences prior to and during the communication process Potter & Perry, 2019 6 Elements of Communication Potter & Perry, 2019 7 7 Forms of Communication Verbal – The use of spoken or written words What do we need to consider when using verbal forms of communication? Potter & Perry, 2019 8 8 Forms of Communication Non Verbal – Transmission of message that do not involve spoken or written words. Using our senses to communicate How do non-verbal communication techniques affect communication? Potter & Perry, 2019 9 9 Zones of Personal Space Can you think of a practice setting where this will be especially MIDTERM REVIEW PNC 121 What are some of the common themes in nursing? What issues and trends are affecting RPNs? Understand the different Canadian Health Care practice settings Can you think of other consumers of long-term care outside of whom you might expect? Understand the types of nurses in Ontario, their education and roles Review the 7 Professional Standards from the CNO and how to meet them What is: Fitness to practice? Duty to provide care? What are the Seneca College Practice Concepts? How does the student nurse meet them? COMMUNICATION Includes: Levels of communication The communication process Forms of Communication Understand cultural norms in communication Phases of the Helping Relationship Factors affecting communication Therapeutic communication techniques Barriers to communication The CNO Therapeutic Nurse-Client Relationship Know the 5 components Understand the 4 standard statements and how they apply to nursing Understand giving and receiving feedback in nursing COMMUNICATION Understand sources of data Describe the 3 stages of the interview Types of questions for interviewing Interviewing clients with special needs Communication amongst professionals – assertive communication, SBAR What are the important nursing considerations for the following? Telephone and verbal orders Change of shift reports Transfer reports Documentation What is the purpose of documentation? What is the purpose of a medical chart? Remember the ethical and legal considerations for documentation and how they connect to the CNO Documentation Standard Electronic Documentation How do we maintain security for electronic records. How does PHIPA affect computerized documentation? Guidelines for Quality Documentation Factual Accurate Complete Current Organized Compliant with standards Methods of Documentation Narrative SOAP, PIE & DAR Charting by exception Critical pathways Written orders Incident or occurrence reports Research Identify where the best sources of research may be found for the practice of nursing and what type of research this may be.
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